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加拿大等待内镜鼻窦手术的慢性鼻窦炎患者中合并疼痛和抑郁的发生率及负担

Incidence and burden of comorbid pain and depression in patients with chronic rhinosinusitis awaiting endoscopic sinus surgery in Canada.

作者信息

Hanna Bassem M N, Crump R Trafford, Liu Guiping, Sutherland Jason M, Janjua Arif S

机构信息

Otolaryngology - Head and Neck Surgery, University of British Columbia, Vancouver, BC, Canada.

Department of Surgery, University of Calgary, Calgary, Canada.

出版信息

J Otolaryngol Head Neck Surg. 2017 Mar 27;46(1):23. doi: 10.1186/s40463-017-0205-3.

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.

CONCLUSION

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.

摘要

背景

本研究为等待鼻内镜鼻窦手术的慢性鼻窦炎患者的鼻窦症状与总体生活质量之间的关联提供了重要见解。利用术前收集的患者报告信息,主要目的是报告患者术前的鼻窦症状及其与自我报告的疼痛和抑郁的关联。次要目的是报告样本中报告有严重睡眠问题的患者的抑郁和疼痛水平。

方法

这是一项横断面研究,前瞻性收集了加拿大一个大城市地区261名被列入择期鼻内镜鼻窦手术等候名单的患者的患者报告结局。

结果

较年轻的患者和有其他合并症的患者最有可能报告慢性鼻窦炎的显著症状以及严重的相关疼痛和抑郁。在初步分析中,报告有慢性鼻窦炎显著症状的患者更有可能报告中度抑郁或高度疼痛(p < 0.01)。随后,有严重睡眠问题的慢性鼻窦炎患者有82%可能报告中度或重度抑郁和疼痛。

结论

为了改善等待鼻内镜鼻窦手术患者的健康相关生活质量,可考虑对抑郁和疼痛进行术前管理。由于抑郁和疼痛非常普遍,有严重睡眠问题的患者可能是优先获得治疗的对象。

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