Long-Term Outcomes in Sinus Surgery: A New Tool for Measuring Health-Related Quality of Life.
The 6-question EuroQol 5-Dimension Health Assessment (EQ-5D) is a widely used, simple instrument that monitors general health-related quality of life (HRQoL) in chronic disease. It has not previously been applied to US patients undergoing endoscopic sinus surgery (ESS).



Prospective cohort study.



Academic Medical Center.



The study population consisted of 267 patients with chronic rhinosinusitis (CRS) who completed 2 disease-specific instruments-the Chronic Sinusitis Survey (CSS) and the Sinonasal Outcomes Test-22 (SNOT-22)-and 1 general health-related quality-of-life instrument-the EQ-5D-before and after ESS for CRS. Baseline scores were compared to those collected 3 and 12 months after surgery and to the general US population.



Surveys were completed at all time points by 186 patients, for a response rate of 69.7%. Patients with CRS, when compared to the US population, reported more problems in the domains of pain/discomfort (73.1% vs 40.8%, P < .01), anxiety/depression (50.5% vs 26.4%, P < .01), and usual activities (30.6% vs 15.0%, P < .01). One year following ESS, there was a significant decrease in patients who reported problems with pain/discomfort (54.3%, P < .001), anxiety/depression (30.6%, P < .001), and usual activities (21.5%, P < .01). After surgery, CRS anxiety/depression scores were no different from those of the US general population. Chronic Sinusitis Survey and SNOT-22 scores demonstrated similar postoperative improvements.



The EQ-5D assessment provides meaningful general health outcomes data with low patient burden. Application of this instrument demonstrated long-term improvement in the quality of life of patients who undergo sinus surgery.
Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA Department of Otology and Laryngology, Harvard Medical School, Boston, Massachusetts, USA aaron_remenschneider@meei.harvard.edu.
Aaron K
AK
Remenschneider
Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA.
Laura
L
D'Amico
Department of Surgery, Washington Veterans Affairs Medical Center, Department of Otolaryngology, MedStar Washington Hospital Center, Washington, DC, USA.
Jamie R
JR
Litvack
Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA Department of Otology and Laryngology, Harvard Medical School, Boston, Massachusetts, USA.
Stacey T
ST
Gray
Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA Department of Otology and Laryngology, Harvard Medical School, Boston, Massachusetts, USA.
Eric H
EH
Holbrook
Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA Department of Otology and Laryngology, Harvard Medical School, Boston, Massachusetts, USA.
Richard
R
Gliklich
Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA Department of Otology and Laryngology, Harvard Medical School, Boston, Massachusetts, USA.
Ralph
R
Metson
D000328:Adult; D000368:Aged; D002908:Chronic Disease; D005260:Female; D005500:Follow-Up Studies; D006785:Hospitals, University; D006801:Humans; D008297:Male; D008875:Middle Aged; D057605:Natural Orifice Endoscopic Surgery / Q000379:methods; D017060:Patient Satisfaction; D011446:Prospective Studies; D011788:Quality of Life; D012220:Rhinitis / Q000601:surgery*; D012852:Sinusitis / Q000601:surgery*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
EQ-5D; chronic rhinosinusitis; clinical outcomes; sinus surgery; sinusitis; utility values