Long-term utility outcomes in patients undergoing endoscopic sinus surgery

Area of Science:

• Otolaryngology
• Health Economics
• Quality of Life Research

Background:

• Chronic rhinosinusitis (CRS) significantly impacts patient quality of life.
• Refractory CRS cases often require surgical intervention, such as endoscopic sinus surgery (ESS).
• Understanding long-term health-state utility is crucial for evaluating the sustained benefits of ESS.

Purpose of the Study:

• To define the long-term health-state utility outcomes in patients who underwent ESS for refractory CRS.
• To assess the stability and magnitude of utility improvements post-ESS over an extended follow-up period.
• To compare long-term utility outcomes with baseline, short-term follow-up, and general population norms.

Main Methods:

• A prospective, longitudinal cohort study design was employed.
• The SF-12 survey was administered to patients, with responses converted to SF-6D utility scores.
• Analysis focused on mean overall long-term utility, annual changes, and subgroup variations, with a mean follow-up of 5.2 years.

Main Results:

• A total of 83 patients provided long-term data, showing a mean overall utility score of 0.80, a significant improvement from baseline (0.67) and short-term (0.75) levels (P = .002).
• Over 54% of patients achieved utility scores comparable to or exceeding US population norms (0.81).
• Significant annual improvements in utility were observed post-ESS (P < .028), with all CRS subgroups showing sustained benefits (P < .001), including continued gains in revision ESS cases.

Conclusions:

• Endoscopic sinus surgery leads to stable and significant long-term improvements in health-state utility for patients with refractory CRS.
• Patients undergoing ESS for refractory CRS often achieve a health state comparable to the general US population.
• The positive impact of ESS on quality of life, as measured by utility scores, is sustained over several years post-procedure.