Shekhar K Gadkaree, Jennifer C Fuller, Natalie S Justicz, Rachel E Weitzman, Adeeb Derakhshan, Suresh Mohan, Robin W Lindsay
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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.</p><p><strong>Exposure: </strong>Functional septorhinoplasty.</p><p><strong>Main outcomes and measures: </strong>Preoperative and postoperative EQ-5D scores were compared to evaluate improvement in overall health after septorhinoplasty.</p><p><strong>Results: </strong>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).</p><p><strong>Conclusions and relevance: </strong>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.</p><p><strong>Level of evidence: </strong>3.</p>","PeriodicalId":14538,"journal":{"name":"JAMA facial plastic surgery","volume":"21 5","pages":"381-386"},"PeriodicalIF":0.0000,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1001/jamafacial.2019.0234","citationCount":"9","resultStr":"{\"title\":\"Health Utility Values as an Outcome Measure in Patients Undergoing Functional Septorhinoplasty.\",\"authors\":\"Shekhar K Gadkaree, Jennifer C Fuller, Natalie S Justicz, Rachel E Weitzman, Adeeb Derakhshan, Suresh Mohan, Robin W Lindsay\",\"doi\":\"10.1001/jamafacial.2019.0234\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Importance: </strong>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.</p><p><strong>Objective: </strong>To use the EuroQol 5-Dimension (EQ-5D) questionnaire to evaluate nasal obstruction outcomes after septorhinoplasty and to determine HUVs.</p><p><strong>Design, setting, and participants: </strong>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.</p><p><strong>Exposure: </strong>Functional septorhinoplasty.</p><p><strong>Main outcomes and measures: </strong>Preoperative and postoperative EQ-5D scores were compared to evaluate improvement in overall health after septorhinoplasty.</p><p><strong>Results: </strong>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).</p><p><strong>Conclusions and relevance: </strong>Nasal obstruction is associated with significant detriment to overall health, in line with other chronic conditions affecting the US population. 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Health Utility Values as an Outcome Measure in Patients Undergoing Functional Septorhinoplasty.
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, and participants: 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 and measures: 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.
期刊介绍：
Facial Plastic Surgery & Aesthetic Medicine (Formerly, JAMA Facial Plastic Surgery) is a multispecialty journal with a key mission to provide physicians and providers with the most accurate and innovative information in the discipline of facial plastic (reconstructive and cosmetic) interventions.
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