Impact of age on outcomes following endoscopic sinus surgery for chronic rhinosinusitis Open Access

Crosby, Dana (Fall 2018)

Permanent URL: https://etd.library.emory.edu/concern/etds/ff365638h?locale=en
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Abstract

Background: Chronic rhinosinusitis (CRS) is a common condition, which affects people

of all ages and has a dramatic negative impact on quality of life (QOL). There are many

factors that can impact CRS outcomes following Endoscopic Sinus Surgery (ESS) to treat

CRS. The goal of this study is to determine if there are differences in outcomes by age

group following ESS for CRS utilizing preoperative and postoperative 22-item Sino-

Nasal Outcome Test (SNOT-22) scores.

Methods: Data from 1,252 adult CRS patients electing to undergo ESS (2007-2018)

were collected retrospectively. The median age of 50 was used to divide the data into two

groups for comparison of the impact of age on SNOT-22 scores at each time point

including preoperative, three, six and twelve months after surgery. Changes of SNOT-22

scores were analyzed using a mixed models analysis in order to determine the effect of

age.

Results: The mean age of patients was 48.6 years. Males comprised 55.2% of the

patients and most patients were white (87.0%). Polyps were present in 53.9% of patients.

Mean SNOT-22 score was 41.0 and was higher in patients younger than 50 years old

compared to those of at least 50 years of age. After adjusting for gender, race, polyp

status, and number of prior ESS, patients younger than 50 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, 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).

Conclusions: 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 have the same SNOT-22 scores at three and six months post-ESS.

The rate of change of SNOT-22 scores at three and six months is not different between

those younger than 50 years and those of at least 50 years.

Table of Contents

CHAPTER I (Introduction)

Introduction……………………………………………………………….....1

Purpose of the study………………………………………………………..7

Public health purpose of the study……………………………………..7

Goals of the study…………………………………………………………...7

CHAPTER II (Manuscript)

Abstract…………………………………………………………………….....10

Introduction………………………………………………………………….12

Materials and Methods…………………………………………………….14

Results………………………………………………………………………....16

Discussion………………………………………………………………….....18

Conclusions…………………………………………………………………...21

Tables and Figures…………………………………………………………..22

CHAPTER III (Results)

Descriptive Analysis………………………………………………….........27

Effect of age on SNOT-22 score……………………………………….....28

CHAPTER IV (Discussion)

Discussion…………………………………………………………………......32

Public health implications…………………………………………………36

Future directions………………………………………………………….... 36

REFERENCES…………………………………………………………….. .....38

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