title: Incidence and burden of comorbid pain and depression in patients with chronic rhinosinusitis awaiting endoscopic sinus surgery in Canada.
abstract: BACKGROUND
  This study sheds important light on the association between sino-nasal symptoms and global quality of life in patients with chronic rhinosinusitis waiting for endoscopic sinus surgery. Using patient-reported information collected pre-operatively, the primary objective was to report on patients' pre-surgical sino-nasal symptoms and their association with self-reported pain and depression. The secondary objective was to report on levels of depression and pain among patients in the sample reporting severe sleep problems.
  
  
  METHODS
  This is a cross-sectional study of patient-reported outcomes collected prospectively from a cohort of 261 patients assigned to the wait list for elective endoscopic sinus surgery in a large urban region of Canada.
  
  
  RESULTS
  Younger patients and patients with other medical comorbidities were most likely to report significant symptoms of chronic rhinosinusitis and substantial associated pain and depression. In the primary analyses, patients reporting significant symptoms of chronic rhinosinusitis were more likely to report moderate depression or high pain (p < 0.01). Subsequently, chronic rhinosinusitis patients with severe sleep problems were 82% likely to report moderate or severe depression and pain.
  
  
  CONCLUSIONS
  Preoperative management of depression and pain may be considered in order to improve the health-related quality of life of patients waiting for ESS. As depression and pain were highly prevalent, patients with severe sleep problems may be candidates for prioritized access.
authors.affiliation: Otolaryngology - Head and Neck Surgery, University of British Columbia, Vancouver, BC, Canada.
authors.forename: Bassem M N
authors.initials: BM
authors.lastname: Hanna
authors.affiliation: Department of Surgery, University of Calgary, Calgary, Canada.
authors.forename: R Trafford
authors.initials: RT
authors.lastname: Crump
authors.affiliation: Centre for Health Services and Policy Research, School of Population and Public Health, University of British Columbia, 201 - 2206 East Mall, V6T 1Z3, Vancouver, Canada.
authors.forename: Guiping
authors.initials: G
authors.lastname: Liu
authors.affiliation: Centre for Health Services and Policy Research, School of Population and Public Health, University of British Columbia, 201 - 2206 East Mall, V6T 1Z3, Vancouver, Canada. jason.sutherland@ubc.ca.
authors.forename: Jason M
authors.initials: JM
authors.lastname: Sutherland
authors.affiliation: Otolaryngology - Head and Neck Surgery, University of British Columbia, Vancouver, BC, Canada.
authors.forename: Arif S
authors.initials: AS
authors.lastname: Janjua
mesh_terms: D000328:Adult; D000368:Aged; D002170:Canada; D002908:Chronic Disease; D017281:Cost of Illness; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000453:epidemiology*; D004724:Endoscopy; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000453:epidemiology*; D000071066:Patient Reported Outcome Measures; D012220:Rhinitis / Q000150:complications* / Q000523:psychology / Q000601:surgery; D012852:Sinusitis / Q000150:complications* / Q000523:psychology / Q000601:surgery; D063189:Symptom Assessment; D014850:Waiting Lists
keywords: Chronis sinusitis; Depression; Endoscopic sinus surgery; Pain; Patient-reported outcomes; Quality of life; Sleep