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The impact of comorbid depression in chronic rhinosinusitis on post-operative sino-nasal quality of life and pain following endoscopic sinus surgery Ospina, Javier; Liu, Guiping; Crump, Trafford; Sutherland, Jason M.; Janjua, Arif

Abstract

Background: Depression and chronic pain are debilitating disorders that co-exist with many chronic diseases. Chronic rhinosinusitis (CRS) is no exception. Nonetheless, little is known about the association between these co-related conditions and the treatment of CRS. The objective of this study is to measure outcomes following endoscopic sinus surgery (ESS) in CRS patients reporting significant pre-operative depression and pain. Methods: This is a prospective longitudinal cohort study examining patients with CRS who had failed maximal medical therapy and subsequently underwent ESS. Participants completed a several patient-reported outcome (PRO) instruments pre-operatively and 6 months post-operatively. The PROs included the Sinonasal Outcome Test-22 (SNOT-22), the Patient Health Questionnaire (PHQ-9) measuring symptoms of depression and an assessment of chronic pain using the pain intensity (P), interference with enjoyment of life (E) and general (G) activity instrument, the PEG instrument. Results: The study had 142 participants complete their pre-operative and post-operative surveys. The participation rate was 40.1% among eligible patients. The prevalence of at least moderate depression was 22 patients (15.5%) among participants. Compared with non-depressed participants, the pre-operative sino-nasal disease burden and pain scores were higher among depressed participants (p <  0.001) and the gain in health following surgery was smaller (p <  0.001). Conclusions: Pre-operative disease burden is higher among depressed patients. Post-operative gains in sino-nasal quality of life attributable to endoscopic sinus surgery were significantly smaller among depressed participants. Pre-operative screening for depression could identify opportunities for medical intervention and improve outcomes among CRS patients.

Item Metadata

Title
The impact of comorbid depression in chronic rhinosinusitis on post-operative sino-nasal quality of life and pain following endoscopic sinus surgery
Creator
Ospina, Javier; Liu, Guiping; Crump, Trafford; Sutherland, Jason M.; Janjua, Arif
Contributor
University of British Columbia. Centre for Health Services and Policy Research
Publisher
BioMed Central
Date Issued
2019-04-30
Description
Background: Depression and chronic pain are debilitating disorders that co-exist with many chronic diseases. Chronic rhinosinusitis (CRS) is no exception. Nonetheless, little is known about the association between these co-related conditions and the treatment of CRS. The objective of this study is to measure outcomes following endoscopic sinus surgery (ESS) in CRS patients reporting significant pre-operative depression and pain. Methods: This is a prospective longitudinal cohort study examining patients with CRS who had failed maximal medical therapy and subsequently underwent ESS. Participants completed a several patient-reported outcome (PRO) instruments pre-operatively and 6 months post-operatively. The PROs included the Sinonasal Outcome Test-22 (SNOT-22), the Patient Health Questionnaire (PHQ-9) measuring symptoms of depression and an assessment of chronic pain using the pain intensity (P), interference with enjoyment of life (E) and general (G) activity instrument, the PEG instrument. Results: The study had 142 participants complete their pre-operative and post-operative surveys. The participation rate was 40.1% among eligible patients. The prevalence of at least moderate depression was 22 patients (15.5%) among participants. Compared with non-depressed participants, the pre-operative sino-nasal disease burden and pain scores were higher among depressed participants (p <  0.001) and the gain in health following surgery was smaller (p <  0.001). Conclusions: Pre-operative disease burden is higher among depressed patients. Post-operative gains in sino-nasal quality of life attributable to endoscopic sinus surgery were significantly smaller among depressed participants. Pre-operative screening for depression could identify opportunities for medical intervention and improve outcomes among CRS patients.
Subject
Chronic rhinosinusitis; Endoscopic sinus surgery; Quality of life; Symptom severity; Patient-reported outcomes
Genre
Article
Type
Text
Language
eng
Date Available
2019-05-22
Provider
Vancouver : University of British Columbia Library
Rights
Attribution 4.0 International (CC BY 4.0)
DOI
10.14288/1.0378917
URI
http://hdl.handle.net/2429/70258
Affiliation
Medicine, Faculty of; Other UBC; Population and Public Health (SPPH), School of; Surgery, Department of
Citation
Journal of Otolaryngology - Head & Neck Surgery. 2019 Apr 30;48(1):18
Publisher DOI
10.1186/s40463-019-0340-0
Peer Review Status
Reviewed
Scholarly Level
Faculty
Copyright Holder
The Author(s).
Rights URI
http://creativecommons.org/licenses/by/4.0/
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Attribution 4.0 International (CC BY 4.0)