1. Does comorbid obesity impact quality of life outcomes in patients undergoing endoscopic sinus surgery?
- Author
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Steele, Toby O, Mace, Jess C, DeConde, Adam S, Xiao, Christopher C, Storck, Kristina A, Gudis, David A, Schlosser, Rodney J, Soler, Zachary M, and Smith, Timothy L
- Subjects
Health Services ,Clinical Research ,Clinical Trials and Supportive Activities ,Obesity ,Nutrition ,7.1 Individual care needs ,Management of diseases and conditions ,Oral and gastrointestinal ,Metabolic and endocrine ,Adult ,Aged ,Body Mass Index ,Chronic Disease ,Comorbidity ,Endoscopy ,Female ,Follow-Up Studies ,Humans ,Male ,Middle Aged ,Paranasal Sinuses ,Prevalence ,Prospective Studies ,Quality of Life ,Rhinitis ,Sinusitis ,Treatment Outcome ,United States ,sinusitis ,endoscopy ,chronic disease ,quality of life ,obesity ,overweight ,body mass index ,Immunology - Abstract
BackgroundBoth obesity and chronic rhinosinusitis (CRS) are characterized by inflammation. Furthermore, both disease processes are independently associated with decreases in quality-of-life (QOL). We sought to investigate the role of comorbid obesity in QOL outcomes in CRS patients undergoing endoscopic sinus surgery (ESS).MethodsAdult patients with medically refractory CRS (n = 241) were prospectively enrolled into a multi-institutional treatment outcomes investigation. Body mass index (BMI) calculations were used to differentiate patient weight groups (normal weight: 18.5 to 24.9, overweight: 25.0 to 29.9; and obese: ≥30.0). Preoperative and postoperative QOL (Rhinosinusitis Disability Index [RSDI] and the 22-item Sino-Nasal Outcome Test [SNOT-22]) were evaluated compared across BMI groups and obesity subclasses.ResultsThe prevalence of comorbid obesity was 41% (n = 99). Higher prevalence of comorbid disease was found across increasing BMI groups including diabetes mellitus, asthma, and depression. No significant differences were found in mean preoperative QOL measures between any BMI groups. Significant improvement between preoperative and postoperative QOL mean scores (p ≤ 0.050) was found for all BMI groups. Despite no significant difference in mean QOL improvement between BMI groups (p ≥ 0.142), overweight and obese patients reported reduced relative mean percentage (%) improvement compared to normal weight participants on the RSDI total score (33% and 37% vs 55%, respectively) and SNOT-22 total score (29% and 40% vs 48%, respectively).ConclusionPatients with comorbid obesity experience significant improvement in average QOL gains following ESS though the percentage of relative improvement in QOL may be decreased in patients with comorbid obesity and CRS as compared to those without.
- Published
- 2015