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Advanced age adversely affects chronic rhinosinusitis surgical outcomes
- Source :
- Int Forum Allergy Rhinol
- Publication Year :
- 2019
-
Abstract
- Background Patient-specific and disease-specific factors shape the course of chronic rhinosinusitis (CRS) and its response to treatment, with optimal management involving interventions tailored to these factors. Recent evidence suggests CRS inflammatory signatures depend on age. The objective of this study was to determine whether age also influences quality-of-life (QOL) and postoperative outcomes. Methods Retrospective analysis of prospectively collected QOL data from 403 adults with medically refractory CRS who underwent functional endoscopic sinus surgery (FESS) at a tertiary care medical center between 2014 and 2018 was undertaken. Total and subdomain scores from the 22-item Sino-Nasal Outcome Test (SNOT-22) and the Short Form 8 Health Survey (SF-8) measure of general health completed at preoperative and postoperative visits were reviewed. Results Patients were divided into young (18 to 39 years, n = 100), middle-aged (40 to 59 years, n = 172), and elderly (≥60 years, n = 131) groups. Baseline total SNOT-22 scores differed between groups (p = 0.01), with middle-aged patients having the highest symptom burden and elderly patients having the lowest. Similar patterns were observed for SNOT-22 subdomains. Elderly patients reported smaller improvements and were less likely to achieve a minimally important clinical difference. CRS patients had worse SF-8 scores compared to the general population, and elderly patients were the least likely to match population norms following surgery. Age was an independent predictor of QOL outcomes after FESS. Conclusion Age may play a significant role in CRS pathophysiology, symptom burden, and surgical outcomes. Elderly patients report smaller improvements in disease-specific and general health QOL after surgery. CRS management in the elderly population should incorporate age-dependent differences in symptom burden and expectations into treatment algorithms.
- Subjects :
- Adult
Male
medicine.medical_specialty
Adolescent
Chronic rhinosinusitis
Population
Nasal Surgical Procedures
Psychological intervention
Tertiary care
Article
03 medical and health sciences
Young Adult
0302 clinical medicine
Quality of life
Internal medicine
Paranasal Sinuses
medicine
Immunology and Allergy
Humans
Sinusitis
030223 otorhinolaryngology
education
Aged
Rhinitis
Aged, 80 and over
education.field_of_study
business.industry
Age Factors
Endoscopy
Functional endoscopic sinus surgery
Middle Aged
medicine.disease
Prognosis
Optimal management
humanities
United States
Treatment Outcome
030228 respiratory system
Otorhinolaryngology
Chronic Disease
Quality of Life
Female
business
Subjects
Details
- ISSN :
- 20426984
- Volume :
- 9
- Issue :
- 10
- Database :
- OpenAIRE
- Journal :
- International forum of allergyrhinology
- Accession number :
- edsair.doi.dedup.....659bb8f6b1ddd09316b275b0e1ed4e21