复发性急性鼻-鼻窦炎内镜鼻窦手术后的生产率结果
Productivity outcomes following endoscopic sinus surgery for recurrent acute rhinosinusitis.
作者信息
Steele Toby O, Detwiller Kara Y, Mace Jess C, Strong E Bradley, Smith Timothy L, Alt Jeremiah A
机构信息
Department of Otolaryngology-Head and Neck Surgery, University of California, Davis Medical Center, Sacramento, California, U.S.A.
Division of Rhinology and Sinus/Skull Base Surgery, Oregon Sinus Center, Department of Otolaryngology-Head and Neck Surgery, Oregon Health & Science University, Portland, Oregon, U.S.A.
出版信息
Laryngoscope. 2016 May;126(5):1046-53. doi: 10.1002/lary.25705. Epub 2016 Jan 9.
OBJECTIVES/HYPOTHESIS: We sought to evaluate preoperative and postoperative productivity losses and quality of life (QOL) impairment reported by patients with recurrent acute rhinosinusitis (RARS) as compared to patients with chronic rhinosinusitis without nasal polyposis (CRSsNP).
STUDY DESIGN
Prospective, multi-institutional, nested case-control.
METHODS
Participants with RARS (n = 20) and CRSsNP (n = 20) undergoing endoscopic sinus surgery (ESS) were enrolled as part of a prospective cohort study. For comparison, participants diagnosed with RARS cases were age/gender-matched to control participants diagnosed with CRSsNP using a 1:1 ratio.
RESULTS
RARS and CRSsNP participants were followed for ∼14 months postoperatively. Productivity losses were reported as the number of days missed from normal productive activities out of the previous 90 days. RARS participants reported similar baseline productivity losses (12.6 ± 27.1 [standard deviation]) as participants with CRSsNP (11.7 ± 20.9; P = .314). Postoperatively, improvement in productivity losses was similar between RARS participants and CRSsNP controls (-6.7 ± 20.0 vs. -9.8 ± 19.1; P = .253). Preoperative and postoperative disease-specific QOL measures (Sino-Nasal Outcomes Test-22 and Rhinosinusitis Disability Index) were similar between the two groups. RARS participants reported a significant decrease in days of previous antibiotic (P = .009) and nasal decongestant (P = .004) use following ESS, whereas participants with CRSsNP reported a significant decrease in antibiotic (P = .002) and oral corticosteroid use (P = .002).
CONCLUSIONS
RARS patients report baseline productivity losses and disease-specific QOL impairment to levels that parallel those with CRSsNP. Patients with RARS report improvement in QOL following ESS in all disease-specific QOL measures and in several medication measures. Productivity losses and postoperative improvements are similar between patients with RARS and CRSsNP.
LEVEL OF EVIDENCE
3b Laryngoscope, 126:1046-1053, 2016.
目的/假设：我们试图评估复发性急性鼻窦炎（RARS）患者与无鼻息肉的慢性鼻窦炎（CRSsNP）患者术前和术后报告的生产力损失及生活质量（QOL）损害情况。
研究设计
前瞻性、多机构、巢式病例对照研究。
方法
作为一项前瞻性队列研究的一部分，纳入了20例接受鼻内镜鼻窦手术（ESS）的RARS患者和20例CRSsNP患者。为进行比较，按照1:1的比例将诊断为RARS的患者与诊断为CRSsNP的对照患者进行年龄/性别匹配。
结果
RARS和CRSsNP患者术后随访约14个月。生产力损失以过去90天内正常生产活动缺勤天数来报告。RARS患者报告的基线生产力损失（12.6±27.1[标准差]）与CRSsNP患者（11.7±20.9；P = 0.314）相似。术后，RARS患者和CRSsNP对照患者的生产力损失改善情况相似（-6.7±20.0对-9.8±19.1；P = 0.253）。两组术前和术后疾病特异性生活质量指标（鼻窦结局测试-22和鼻窦炎残疾指数）相似。RARS患者报告ESS后之前使用抗生素的天数（P = 0.009）和鼻减充血剂的天数（P = 0.004）显著减少，而CRSsNP患者报告抗生素使用天数（P = 0.002）和口服糖皮质激素使用天数（P = 0.002）显著减少。
结论
RARS患者报告的基线生产力损失和疾病特异性生活质量损害程度与CRSsNP患者相当。RARS患者在所有疾病特异性生活质量指标和多项用药指标方面报告ESS后生活质量有所改善。RARS患者和CRSsNP患者的生产力损失及术后改善情况相似。
证据级别
3b 《喉镜》杂志，2016年，第126卷，第1046 - 1053页
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