Predictors of Sinonasal Quality of Life and Nasal Morbidity after Endoscopic Transsphenoidal Surgery: A Multicenter Study

2015 ◽  
Vol 76 (S 01) ◽  
Author(s):  
Andrew Little ◽  
Daniel Kelly ◽  
John Milligan ◽  
Chester Griffiths ◽  
Ricardo Carrau ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Multicenter Study ◽  
Transsphenoidal Surgery ◽  
Endoscopic Transsphenoidal Surgery

scholarly journals Predictors of sinonasal quality of life and nasal morbidity after fully endoscopic transsphenoidal surgery

2015 ◽  
Vol 122 (6) ◽  
pp. 1458-1465 ◽  
Author(s):  
Andrew S. Little ◽  
Daniel Kelly ◽  
John Milligan ◽  
Chester Griffiths ◽  
Daniel M. Prevedello ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Clinical Trial ◽  
Health Status ◽  
Transsphenoidal Surgery ◽  
Pituitary Surgery ◽  
Nasal Packing ◽  
Nasal Endoscopy ◽  
Endoscopic Transsphenoidal Surgery ◽  
Patient Reported

OBJECT Despite the increasing application of endoscopic transsphenoidal surgery for pituitary lesions, the prognostic factors that are associated with sinonasal quality of life (QOL) and nasal morbidity are not well understood. The authors examine the predictors of sinonasal QOL and nasal morbidity in patients undergoing fully endoscopic transsphenoidal surgery. METHODS An exploratory post hoc analysis was conducted of patients who underwent endoscopic pituitary surgery and were enrolled in a prospective multicenter QOL study. End points of the study included patient-reported sinonasal QOL and objective nasal endoscopy findings. Multivariate models were developed to determine the patient and surgical factors that correlated with QOL at 2 weeks through 6 months after surgery. RESULTS This study is a retrospective review of a subgroup of patients studied in the clinical trial “Rhinological Outcomes in Endonasal Pituitary Surgery” (clinical trial no. NCT01504399, clinicaltrials.gov). Data from 100 patients who underwent fully endoscopic transsphenoidal surgery were included. Predictors of a lower postoperative sinonasal QOL at 2 weeks were use of nasal splints (p = 0.039) and female sex at the trend level (p = 0.061); at 3 months, predictors of lower QOL were the presence of sinusitis (p = 0.025), advancing age (p = 0.044), and use of absorbable nasal packing (p = 0.014). Health status (multidimensional QOL) was also predictive at 2 weeks (p = 0.001) and 3 months (p < 0.001) and was the only significant predictor of sinonasal QOL at 6 months (p < 0.001). A Kaplan-Meier analysis was performed to study time to resolution of nasal crusting, mucopurulence, and synechia as observed during nasal endoscopy after surgery. The mean time (± SEM) to absence of nasal crusting was 16.3 ± 2.1 weeks, mucopurulence was 6.2 ± 1.1 weeks, and synechia was 4.4 ± 0.5 weeks. Use of absorbable nasal packing was associated with more severe mucopurulence. CONCLUSIONS Sinonasal QOL following endoscopic pituitary surgery reaches a nadir at 2 weeks and recovers by 3 months postoperatively. Use of absorbable packing and nasal splints, while used in a minority of patients, negatively correlates with early sinonasal QOL. Sinonasal QOL and overall health status are well correlated in the postoperative period, suggesting the important influence of sinonasal QOL on the patient experience.

scholarly journals Comparison of sinonasal quality of life and health status in patients undergoing microscopic and endoscopic transsphenoidal surgery for pituitary lesions: a prospective cohort study

2015 ◽  
Vol 123 (3) ◽  
pp. 799-807 ◽  
Author(s):  
Andrew S. Little ◽  
Daniel F. Kelly ◽  
John Milligan ◽  
Chester Griffiths ◽  
Daniel M. Prevedello ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Cohort Study ◽  
Health Status ◽  
Surgical Technique ◽  
Endoscopic Surgery ◽  
Transsphenoidal Surgery ◽  
Endoscopic Transsphenoidal Surgery ◽  
Patient Reported ◽  
Reported Health

OBJECT Despite the widespread adoption of endoscopic transsphenoidal surgery for pituitary adenomas, the sinonasal quality of life (QOL) and health status in patients who have undergone this technique have not been compared with these findings in patients who have undergone the traditional direct uninostril microsurgical technique. In this study, the authors compared the sinonasal QOL and patient-reported health status after use of these 2 surgical techniques. METHODS The study design was a nonblinded prospective cohort study. Adult patients with sellar pathology and planned transsphenoidal surgery were screened at 4 pituitary centers in the US between October 2011 and August 2013. The primary end point of the study was postoperative patient-reported sinonasal QOL as measured by the Anterior Skull Base Nasal Inventory–12 (ASK Nasal-12). Supplementary end points included patient-reported health status estimated by the 8-Item Short Form Health Survey (SF-8) and EuroQol (EQ)-5D-5L instruments, and sinonasal complications. Patients were followed for 6 months after surgery. RESULTS A total of 301 patients were screened and 235 were enrolled in the study. Of these, 218 were analyzed (111 microsurgery patients, 107 endoscopic surgery patients). Demographic and tumor characteristics were similar between groups (p ≥ 0.12 for all comparisons). The most common complication in both groups was sinusitis (7% in the microsurgery group, 13% in the endoscopic surgery group; p = 0.15). Patients treated with the endoscopic technique were more likely to have postoperative nasal debridements (p < 0.001). The ASK Nasal-12 and SF-8 scores worsened substantially for both groups at 2 weeks after surgery, but then returned to baseline at 3 months. At 3 months after surgery, patients treated with endoscopy reported statistically better sinonasal QOL compared with patients treated using the microscopic technique (p = 0.02), but there were no significant differences at any of the other postoperative time points. CONCLUSIONS This is the first multicenter study to examine the effect of the transsphenoidal surgical technique on sinonasal QOL and health status. The study showed that surgical technique did not significantly impact these patient-reported measures when performed at high-volume centers. Clinical trial registration no.: NCT01504399 (clinicaltrials.gov).

Nasal Morbidity and Quality of Life After Endoscopic Transsphenoidal Surgery: A Single-Center Prospective Study

2019 ◽  
Vol 123 ◽  
pp. e557-e565 ◽  
Author(s):  
Alberto Schreiber ◽  
Giacomo Bertazzoni ◽  
Marco Ferrari ◽  
Vittorio Rampinelli ◽  
Paolo Verri ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Prospective Study ◽  
Transsphenoidal Surgery ◽  
Single Center ◽  
Endoscopic Transsphenoidal Surgery

scholarly journals Reprint of: Impact of endometriosis on quality of life and work productivity: a multicenter study across ten countries

2019 ◽  
Vol 112 (4) ◽  
pp. e137-e152 ◽  
Author(s):  
Kelechi E. Nnoaham ◽  
Lone Hummelshoj ◽  
Premila Webster ◽  
Thomas d'Hooghe ◽  
Fiorenzo de Cicco Nardone ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Multicenter Study ◽  
Work Productivity

scholarly journals Effect of Originator Infliximab Treatment on Disease-Related Hospitalizations, Work Productivity and Activity Impairment, and Health Resource Utilization in Patients with Crohn’s Disease in a Real-Life Setting: Results of a Prospective Multicenter Study in Germany

2020 ◽  
pp. 1-13
Author(s):  
Niels Teich ◽  
Michael Bläker ◽  
Frank Holtkamp-Endemann ◽  
Eric Jörgensen ◽  
Andreas Stallmach ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Multicenter Study ◽  
Work Productivity ◽  
Infliximab Treatment ◽  
Prospective Multicenter Study ◽  
Hospitalization Rates ◽  
The Mean

<b><i>Introduction:</i></b> Infliximab (IFX) therapy is efficacious for inducing and maintaining symptomatic remission in patients with Crohn’s disease (CD), but whether this benefit results in reduced hospitalization rates and therefore may improve patients’ quality of life in an economically sensible way is conflicting so far. <b><i>Methods:</i></b> We conducted a noninterventional, multicenter, open-label, prospective study to evaluate the effect of originator IFX treatment on patient-reported outcomes and disease-related hospitalizations in adult CD patients in Germany treated for the first time with IFX according to label. <b><i>Results:</i></b> Two hundred and ninety-four patients were included in the study. We observed a statistically significant reduction in the number of CD-related hospitalizations from the year before baseline (mean 1.00 per patient, SD ± 0.93) to the mean value of the 1st (0.62, SD ± 0.95) and 2nd year (0.32, SD ± 0.75) of the observation period (<i>p</i> &#x3c; 0.0001). After 3 months of IFX therapy, work productivity and activity increased by an average of 12.6 and 17.1%, respectively. Patient’s clinical outcome was markedly improved as the total CD activity index (CDAI) sum score continuously decreased from baseline to month 24 and the mean score of the total inflammatory bowel disease questionnaire (IBDQ) changed substantially from 141 at baseline to 172 after 24 months of IFX treatment. Additionally, the number of work incapacity days declined. Recently, no new safety issues of IFX have been identified. <b><i>Conclusion:</i></b> In this large, prospective, multicenter study on disease-related hospitalization rates, work productivity, capacity for daily activities, and HRQoL in patients with CD, IFX significantly reduces their hospitalization rates and improves work productivity, daily activity, and quality of life over 24 months.

Multicenter study of peroneal mononeuropathy: clinical, neurophysiologic, and quality of life assessment

2005 ◽  
Vol 10 (3) ◽  
pp. 259-268 ◽  
Author(s):  
Irene Aprile ◽  
Pietro Caliandro ◽  
Giuseppe La Torre ◽  
Pietro Tonali ◽  
Mariangela Foschini ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Multicenter Study ◽  
Life Assessment ◽  
Quality Of Life Assessment
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