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Using preoperative SNOT ‐22 score to inform patient decision for Endoscopic sinus surgery
Author(s) -
Rudmik Luke,
Soler Zachary M.,
Mace Jess C.,
DeConde Adam S.,
Schlosser Rodney J.,
Smith Timothy L.
Publication year - 2015
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1002/lary.25108
Subject(s) - medicine , minimal clinically important difference , chronic rhinosinusitis , observational study , endoscopic sinus surgery , cohort , cohort study , quality of life (healthcare) , subgroup analysis , prospective cohort study , physical therapy , surgery , randomized controlled trial , meta analysis , nursing
Objectives/Hypothesis The purpose of this study is to improve patient understanding of surgical outcomes while they make a preference‐sensitive decision regarding electing endoscopic sinus surgery (ESS) for chronic rhinosinusitis (CRS). Study Design Prospective observational cohort study. Methods Patients with CRS who elected ESS were prospectively enrolled into a multi‐institutional, observational cohort study. Patients' were categorized into 10 preoperative Sino‐Nasal Outcome Test (SNOT‐22) groups based on 10‐point increments beginning with a score of 10 and ending at 110. The proportion of patients achieving a SNOT‐22 minimal clinically important difference (MCID) (9 points) and the percentage of relative improvement (%) for each preoperative SNOT‐22 group were calculated. A subgroup analysis based on polyp status was performed. Results A total of 327 patients were included in this study. Patients with a SNOT‐22 score between 10 and 19 had the lowest chance of achieving an MCID (37.5%) and received a relative mean worsening of their quality of life (QoL) after ESS (+18.8%). Patients with a SNOT‐22 score greater than 30 obtained a greater than 75% chance of achieving an MCID, and there was a relative improvement of 45% in QoL (all < −44.9%) after ESS. Outcomes from the polyp status subgroup analysis were similar to the findings from the overall cohort. Conclusion Outcomes from this study suggest that patients with a preoperative SNOT‐22 score higher than 30 points receive a greater than 75% chance of achieving an MCID and on average obtain a 45% relative improvement in their QoL after ESS. Patients with SNOT‐22 score of less than 20 did not experience improved QoL from ESS. Level of Evidence 2b. Laryngoscope , 125:1517–1522, 2015