Impact of age on outcomes following endoscopic sinus surgery for chronic rhinosinusitis
Impact of age on outcomes following endoscopic sinus surgery for chronic rhinosinusitis
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DOI：
10.1002/alr.22444
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发表时间：
2019-09-26
影响因子：
6.4
通讯作者：
Adappa, Nithin D.
中科院分区：
文献类型：
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作者：
Crosby, Dana L.;Jones, Jeb;Adappa, Nithin D.
背景慢性鼻-鼻窦炎(CRS)是一种常见疾病，影响各个年龄段的人，并对生活质量产生负面影响。这项研究的目的是利用22项鼻-鼻结局测试(SNOT-22)评分，确定鼻内窥镜手术(ESS)治疗CRS后不同年龄的预后差异。方法回顾分析2007-2018年间1252例成人CRS患者行ESS治疗的临床资料。使用50岁的中位年龄将数据分成两组，以比较年龄对术后0、3和6个月的鼻塞-22评分的影响。采用混合模型分析了SNOT-22评分的变化。结果在调整了性别、种族、息肉状况和既往ESSS的数量后，50岁以下的患者在ESS前的平均SNOT-22评分(44.0)高于至少50岁的患者(38.9)。在50岁以下的患者中，鼻塞-22评分在ESS后3个月下降了20.7分，在ESS后6个月下降了16.1分。在ESS术后3个月和6个月，二分年龄组之间的变化率没有显著差异(分别为p=0.7952和p=0.1057)。结论ESS术后两个年龄组的SNOT-22评分均有显著而持久的改善。年龄在50岁以下的患者在ESS前有较高的SNOT-22评分，但在ESS后3个月时收敛到相同的SNOT-22评分。年龄在50岁以下和至少50岁的人，鼻涕-22分的变化率没有差别。
Background Chronic rhinosinusitis (CRS) is a common condition that affects people of all ages and negatively impacts quality of life. The goal of this study was to identify differences in outcomes by age following endoscopic sinus surgery (ESS) for CRS utilizing 22-item Sino-Nasal Outcome Test (SNOT-22) scores. Methods Data from 1252 adult CRS patients electing to undergo ESS (2007-2018) were collected retrospectively. The median age of 50 years was used to divide the data into 2 groups for comparison of the impact of age on SNOT-22 scores at 0, 3, and 6 months after surgery. Changes in SNOT-22 scores were analyzed using a mixed models analysis. Results After adjusting for gender, race, polyp status, and number of prior ESSs, patients younger than 50 years had a higher mean pre-ESS SNOT-22 score (44.0) compared to those of at least 50 years of age (38.9). Among patients younger than 50 years, SNOT-22 scores declined by 20.7 points at 3 months post-ESS and 16.1 points at 6 months post-ESS. The rate of change between the dichotomized age groups was not significantly different at 3 and 6 months post-ESS (p = 0.7952 and p = 0.1057, respectively). Conclusion Both age groups showed significant and durable improvement in SNOT-22 scores after ESS. Patients younger than 50 years of age have higher pre-ESS SNOT-22 scores, but converge to the same SNOT-22 scores by 3 months post-ESS. The rate of change of SNOT-22 scores is not different between those younger than 50 years and those of at least 50 years.