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Effects of Depression on Quality of Life Improvement After Endoscopic Sinus Surgery
Author(s) -
Mace Jess,
Michael Yvonne L.,
Carlson Nichole E.,
Litvack Jamie R.,
Smith Timothy L.
Publication year - 2008
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 - 10.1097/mlg.0b013e31815d74bb
Subject(s) - depression (economics) , endoscopic sinus surgery , medicine , quality of life (healthcare) , surgery , nursing , economics , macroeconomics
Objectives/Hypothesis: To determine whether self‐ reported depression predicts lesser postoperative improvement in health‐related quality of life (HRQoL) after endoscopic sinus surgery (ESS) for chronic rhinosinusitis (CRS). Study Design: Prospective open cohort. Methods: An adult (≥18 yr) cohort of 23 patients with depression and 79 patients without depression undergoing ESS were followed for 12 ± 2 months. Patient characteristics and computed tomography scores were examined preoperatively. Endoscopy scores and two HRQoL measures, the Rhinosinusitis Disability Index (RSDI) and Chronic Sinusitis Survey, were analyzed pre‐ and postoperatively. Univariate and multivariate analyses were used to evaluate outcome differences for patients with depression. Results: There was a significantly higher prevalence of women ( P = .002) and longer duration of follow‐up ( P = .004) for the depressed subgroup. Depressed patients reported significantly lower pre‐ and postoperative HRQoL scores on all RSDI subscales ( P < .05). Without baseline adjustment, depression was not associated with significant differences in postoperative change for disease‐specific HRQoL scores ( P > .10) in multivariate analysis. Conclusions: Depressed patients with CRS present similarly but have worse pre‐ and postoperative HRQoL scores and experience similar disease‐specific QoL improvements from sinus surgery compared with other CRS patients. Sinus surgery is not effective in alleviating the effect of depression on disease‐specific HRQoL, and it is likely that comorbid depression and CRS are operating on independent disease pathways. Additional research and hypothesis testing using continuous, objective measures is warranted.