Dataset Information

Smoking and endoscopic sinus surgery: does smoking volume contribute to clinical outcome.

ABSTRACT:

Background

The effect of tobacco smoking on chronic rhinosinusitis (CRS) is not yet well-delineated. The purpose of this investigation was to evaluate the overall effect of smoking on postoperative outcomes (endoscopic score and health-related quality-of-life [HRQoL]) after endoscopic sinus surgery (ESS) for CRS and to determine if volume of daily smoking impacts outcomes.

Methods

A total of 784 patients with CRS were prospectively enrolled between January 2001 and April 2009 after electing ESS from 1 of 3 academic tertiary care centers. Follow-up longer than 6 months was available on 39 smoking patients. Smoking volume (cigarettes/day) analysis was performed by dichotomizing patients into either of 2 subgroups: light smokers (<20 cigarettes per day) or heavy smokers (≥ 20 cigarettes per day). Primary outcomes were Lund-Kennedy endoscopy scores and 2 disease-specific HRQoL instruments: the Rhinosinusitis Disability Index (RSDI) and Chronic Sinusitis Survey (CSS).

Results

Smokers and nonsmokers experienced similar improvement in HRQoL following surgery (RSDI: p = 0.792 and CSS: p = 0.117). No difference in HRQoL improvements between light smokers and heavy smokers was identified. While overall changes in endoscopy scores did not differ between smokers and nonsmokers, there was a significant difference in the prevalence of worsening postoperative endoscopy scores between heavy smokers, light smokers, and nonsmokers (100%, 33%, and 20%, respectively; p = 0.002).

Conclusion

Active smoking status does not alter postoperative improvement in HRQoL after ESS. Although limited by a small sample size, increasing smoking volume may contribute to worse postoperative endoscopy scores.

SUBMITTER: Rudmik L

PROVIDER: S-EPMC3124774 | biostudies-literature | 2011 May-Jun

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Smoking and endoscopic sinus surgery: does smoking volume contribute to clinical outcome.

Rudmik Luke L Mace Jess C JC Smith Timothy L TL

International forum of allergy & rhinology 20110501 3

<h4>Background</h4>The effect of tobacco smoking on chronic rhinosinusitis (CRS) is not yet well-delineated. The purpose of this investigation was to evaluate the overall effect of smoking on postoperative outcomes (endoscopic score and health-related quality-of-life [HRQoL]) after endoscopic sinus surgery (ESS) for CRS and to determine if volume of daily smoking impacts outcomes.<h4>Methods</h4>A total of 784 patients with CRS were prospectively enrolled between January 2001 and April 2009 afte ...[more]

PMID: 21731825

Similar Datasets

Project description:ImportanceThe opioid epidemic has generated interest in optimizing opioid prescribing after common surgeries. Recent studies have shown a broad range of analgesic prescription patterns following endoscopic sinus surgery (ESS).ObjectiveTo compare the efficacy of different analgesic regimens after ESS.Design, setting, and participantsThis multi-institutional, nonblinded randomized clinical trial was conducted at 6 tertiary centers across the US and Canada and included participants who underwent ESS for acute or chronic rhinosinusitis. The study was conducted from March 2019 to March 2020, and the data were analyzed in November to December 2020.InterventionsAll participants received acetaminophen, 650 mg, as the first-line analgesic. From there, patients were randomized to either oxycodone rescue (oxycodone, 5 mg, as second-line therapy) or ibuprofen rescue (ibuprofen, 600 mg, as second-line therapy, with oxycodone, 5 mg, reserved for breakthrough pain).Main outcomes and measuresBaseline characteristics and disease severity were collected at enrollment. Medication logs, pain scores, and epistaxis measures were collected until postoperative day 7. The primary outcome was the postoperative visual analog scale score for pain. Brief Pain Inventory Pain Severity and Pain Interference Scores were also collected.ResultsA total of 118 patients were randomized (62 [52.5%] oxycodone rescue, 56 [47.5%] ibuprofen rescue; mean [SD] age, 46.7 [16.3] years; 44 women [44.0%]; 83 White [83.0%], 7 Black [7.0%], and 7 Asian individuals [7.0%]). After exclusions for loss to follow-up and noncompliance, 51 remained in the oxycodone rescue group and 49 in the ibuprofen rescue group. The groups had similar demographic characteristics and disease severity. Thirty-two (63%) in the oxycodone rescue group had adequate pain management with acetaminophen only, while 19 (37%) consumed at least 1 oxycodone dose. In the ibuprofen rescue group, 18 (16%) required only acetaminophen, 28 (57%) used only acetaminophen and ibuprofen, and the remaining 13 (26%) consumed 1 or more oxycodone doses. The groups had similar average acetaminophen (9.69 vs 7.96 doses; difference, 1.73; 95% CI, -1.37 to 4.83) and oxycodone (1.89 vs 0.77 doses; difference, 1.13; 95% CI, -0.11 to 2.36) use. Both groups had similar postoperative visual analog scale scores. A subanalysis that compared opioids users with nonusers showed clinically significant lower pain scores in nonusers at multiple postoperative points.Conclusions and relevanceIn this randomized clinical trial, most patients who underwent ESS could be treated postoperatively using a nonopioid regimen of either acetaminophen alone or acetaminophen and ibuprofen. Ibuprofen as a second-line therapy did not reduce overall narcotic consumption, but the overall narcotic use was low in both groups.Trial registrationClinicalTrials.gov Identifier: NCT03783702.

Dataset Information

Smoking and endoscopic sinus surgery: does smoking volume contribute to clinical outcome.

Background

Methods

Results

Conclusion

Publications

Smoking and endoscopic sinus surgery: does smoking volume contribute to clinical outcome.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets