Health Utility Values as an Outcome Measure in Patients Undergoing Functional Septorhinoplasty.
JAMA Facial Plast Surg
; 21(5): 381-386, 2019 Sep 01.
Article
em En
| MEDLINE
| ID: mdl-31120515
ABSTRACT
IMPORTANCE By measuring health utility values (HUVs) for patients with nasal obstruction after septorhinoplasty, the association of nasal congestion with overall health can be measured and the functional outcomes of septorhinoplasty can be determined. OBJECTIVE:
To use the EuroQol 5-Dimension (EQ-5D) questionnaire to evaluate nasal obstruction outcomes after septorhinoplasty and to determine HUVs. DESIGN, SETTING, ANDPARTICIPANTS:
This prospective cohort study included patients who underwent septorhinoplasty for nasal obstruction at a single institution by a single surgeon from January 1, 2013, through December 31, 2017. Participants completed the EQ-5D questionnaire immediately before surgery and postoperatively at 2, 4, 6, and 12 months. The EQ-5D scores were converted to HUVs using population-based data for individuals with chronic diseases. Data were analyzed from May 1 through December 31, 2018. EXPOSURE Functional septorhinoplasty. MAIN OUTCOMES ANDMEASURES:
Preoperative and postoperative EQ-5D scores were compared to evaluate improvement in overall health after septorhinoplasty.RESULTS:
A total of 463 patients (53.8% women; mean [SD] age, 36.8 [15.7] years) who underwent septorhinoplasty and completed EQ-5D surveys at baseline and postoperatively were included in the study population. Overall mean (SD) preoperative HUV was 0.872 (0.01), compared with 1.00 for those with a perfect state of health. On univariate analysis, female sex (mean [SD] HUV, 0.853 [0.01]; P = .004), previous nasal surgery (mean [SD] HUV, 0.85 [0.16]; P = .02), previous septoplasty (mean [SD] HUV, 0.88 [0.15]; P = .02), and previous sinus surgery (mean [SD] HUV, 0.79 [0.20]; P = .009) were associated with significantly lower baseline HUVs. On multivariate regression including these variables, only previous septoplasty was significantly associated with a positive change in mean (SD) HUV (0.88 [0.15] vs 0.85 [0.16]; P = .02). Mean (SD) HUV was significantly improved at 2 months postoperatively to 0.91 (0.14; P = .001) and remained significantly improved from baseline at 12 months, at 0.93 (0.13; P < .001). CONCLUSIONS AND RELEVANCE Nasal obstruction is associated with significant detriment to overall health, in line with other chronic conditions affecting the US population. Functional septorhinoplasty appears to substantially improve overall health, as measured by HUV, in an immediate and sustained fashion. LEVEL OF EVIDENCE 3.
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Bases de dados:
MEDLINE
Assunto principal:
Rinoplastia
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Obstrução Nasal
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Medidas de Resultados Relatados pelo Paciente
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Septo Nasal
Tipo de estudo:
Observational_studies
Limite:
Adult
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Female
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Humans
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Male
Idioma:
En
Revista:
JAMA Facial Plast Surg
Ano de publicação:
2019
Tipo de documento:
Article