Enhanced recovery after surgery protocols in functional endoscopic sinus surgery for patients with chronic rhinosinusitis with nasal polyps

Wu, Xifu; Kong, Weihao; Wang, Wei-Hao; Yuan, Lei; Xu, Hui; Qi, Min; Zhou, Shaoli; Yang, Qintai

doi:10.1097/cm9.0000000000000060

Cited by 15 publications

(44 citation statements)

References 20 publications

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Section: Direct Costsmentioning

confidence: 99%

“…Health care resource utilization and costs HCRU and costs related to CRSwNP were reported in five studies ( Supplementary Table 15) [97][98][99][100][101] . Four studies were conducted in the United States 97,99-101 and one study in China 98 . Two studies were retrospective database analyses 99,100 , one was a retrospective case-control study 97 , one was a randomized controlled trial 98 and one was a population-based survey 101 .…”

Section: Direct Costsmentioning

confidence: 99%

“…Four studies were conducted in the United States 97,99-101 and one study in China 98 . Two studies were retrospective database analyses 99,100 , one was a retrospective case-control study 97 , one was a randomized controlled trial 98 and one was a population-based survey 101 . One US case-control study 97 reported data on systemic prescription usage, medical procedures, HCRU and total health care costs for patients with CRSwNP compared with a matched control group 1 year after diagnosis.…”

Section: Direct Costsmentioning

confidence: 99%

“…Compared with patients who did not undergo FESS, patients with CRSwNP who underwent FESS incurred incremental costs of $13,532 (2016 USD) 97 . Wu et al 98 compared cohorts of patients with CRSwNP undergoing FESS with or without enhanced- Figure 6) 97 . In another study, in-office balloon catheter dilation procedures did not result in a significant decrease in health care utilization for patients with CRSwNP, but Sillers et al 100 found that patients with CRSwNP had greater health care resource use at all time points in the study compared with CRSsNP patients.…”

Section: Direct Costsmentioning

confidence: 99%

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Systematic literature review of humanistic and economic burdens of chronic rhinosinusitis with nasal polyposis

Chen

Zhou

Emmanuel

et al. 2020

Current Medical Research and Opinion

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Objectives: We conducted a systematic literature review (SLR) of randomized controlled trials and real-world evidence (RWE) studies to determine the humanistic (e.g. health-related/disease-specific quality of life [QOL]) and economic (e.g. direct and indirect costs) burdens of chronic rhinosinusitis with nasal polyposis (CRSwNP). Methods: The SLR adhered to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Embase, MEDLINE and Evidence-Based Medicine Reviews databases were searched using OVID. Relevant studies involving adult patients with CRSwNP published between 1 January 2008 and 16 February 2019 were included, with relevant conference abstracts from 1 January 2017, onward. Results: Sino-Nasal Outcomes Test (SNOT)-22 was the most frequently used disease-specific healthrelated QOL/patient-reported outcomes instrument for patients with CRSwNP. Baseline SNOT-22 scores ranged from 25 to 73 for surgical candidates and from 14 to 56 for medically managed patients with CRSwNP. Mean baseline EuroQol-5 Dimensions (EQ-5D) index for patients with CRSwNP ranged from 0.81 to 0.86, and mean baseline Short Form-6 Dimensions (SF-6D) ranged from 0.67 to 0.75. Three months (EQ-5D) and 5 years (SF-6D) post-endoscopic sinus surgery (ESS), rates increased from 0.81 to 0.89 and from 0.69 to 0.80, respectively. One year post-diagnosis, patients with CRSwNP had significantly more systemic prescriptions, underwent significantly more medical procedures, demonstrated greater health care resource utilization and had significantly greater mean health care costs compared with matched controls (all p < .001). Overall, for patients with initial ESS, CRSwNP was associated with higher disease-related expenditures compared with CRS without nasal polyposis (NP), even for patients who did not undergo revision surgery. Conclusions: This SLR identified substantial humanistic burden among surgery candidates. RWE shows that surgeries were used to treat relatively more severe CRSwNP patients as recommended by guidelines. Patient QOL is improved significantly after surgery; however, there is a lack of evidence on patients with revision surgery. Surgery is also associated with higher costs, and the presence of NP was a predictor of revision surgery. Patients with CRSwNP demonstrate greater health care resource utilization and costs compared to those with CRS without NP. Costs associated with different severity of CRSwNP and revision surgery need to be assessed further.

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Section: Direct Costsmentioning

confidence: 99%

Section: Direct Costsmentioning

confidence: 99%

Section: Direct Costsmentioning

confidence: 99%

Section: Direct Costsmentioning

confidence: 99%

See 2 more Smart Citations

Systematic literature review of humanistic and economic burdens of chronic rhinosinusitis with nasal polyposis

Chen

Zhou

Emmanuel

et al. 2020

Current Medical Research and Opinion

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“…ERAS was pioneered by Kehlet8 and has been extended in many disciplines, for instance in the field of otolaryngology, such as head and neck oncological surgery 9–12. In our previous study, the application of ERAS in ESS improved postoperative pain and sleep, while reducing hospital costs and length of hospital stay,13 which may be beneficial in improving the patients' QoL. Therefore, the aim of this study was to assess the improvement in QoL in the perioperative period in ESS by the application of ERAS, using the Chinese version of the 22-item Sinonasal Outcomes Test (SNOT-22).…”

Section: Introductionmentioning

confidence: 86%

<p>Improved perioperative quality of life in endoscopic sinus surgery by application of enhanced recovery after surgery</p>

Wu¹,

Kong²,

Zhu³

et al. 2019

TCRM

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Background: Endoscopic sinus surgery (ESS) has been the definitive treatment for chronic rhinosinusitis (CRS), but the complications caused perioperatively may affect patients’ quality of life (QoL). This study aims to evaluate the effects of enhanced recovery after surgery (ERAS) on improving perioperative QoL in ESS. Materials and methods: Seventy-four patients with chronic rhinosinusitis with nasal polyps (CRSwNP) met the criteria for inclusion. Participants undergoing ESS were randomly divided into an ERAS group and a control group, and QoL assessment was performed using the Chinese version of the 22-item Sinonasal Outcomes Test (SNOT-22). Measurements were administered at baseline, and on postoperative day 1 (POD1), POD3 and POD6. Complications such as nausea/emesis, hemorrhage, aspiration and dizziness were also recorded. Results: The preoperative global SNOT-22 scores (mean ± SD) were 39.89±4.86 in the ERAS group and 40.52±3.61 in the control group ( t =0.643, P =0.522). On POD1, the global SNOT-22 scores increased significantly to 51.77±5.59 and 62.02±3.86 ( t =9.218, P <0.01), and on POD3 they increased to 48.22±6.22 and 51.11±5.14, respectively ( t =2.179, P <0.05). However, the scores recovered to 39.39±4.73 and 40.13±3.31 in the respective groups on POD6, which were lower than but not statistically significant different from the baseline ( t =0.786, P =0.434). There were statistically significant improvements across all subdomains of SNOT-22 for patients in the two groups only in POD1 (all P <0.05). The ERAS group did not have an increased incidence of complications such as nausea/emesis ( χ 2 =0.223, P >0.05), hemorrhage, aspiration and dizziness compared to the control group. Conclusion: ERAS could improve perioperative QoL in patients with CRSwNP undergoing ESS, and SNOT-22 can be used for ERAS evaluation as a patients’ outcome report.

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Enhanced Recovery After Surgery Guidelines and Hospital Length of Stay, Readmission, Complications, and Mortality

Sauro,

Smith,

Ibadin

et al. 2024

JAMA Netw Open

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ImportanceA comprehensive review of the evidence exploring the outcomes of enhanced recovery after surgery (ERAS) guidelines has not been completed.ObjectiveTo evaluate if ERAS guidelines are associated with improved hospital length of stay, hospital readmission, complications, and mortality compared with usual surgical care, and to understand differences in estimates based on study and patient factors.Data SourcesMEDLINE, Embase, Cumulative Index to Nursing and Allied Health Literature, and Cochrane Central were searched from inception until June 2021.Study SelectionTitles, abstracts, and full-text articles were screened by 2 independent reviewers. Eligible studies were randomized clinical trials that examined ERAS-guided surgery compared with a control group and reported on at least 1 of the outcomes.Data Extraction and SynthesisData were abstracted in duplicate using a standardized data abstraction form. The study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Risk of bias was assessed in duplicate using the Cochrane Risk of Bias tool. Random-effects meta-analysis was used to pool estimates for each outcome, and meta-regression identified sources of heterogeneity within each outcome.Main Outcome and MeasuresThe primary outcomes were hospital length of stay, hospital readmission within 30 days of index discharge, 30-day postoperative complications, and 30-day postoperative mortality.ResultsOf the 12 047 references identified, 1493 full texts were screened for eligibility, 495 were included in the systematic review, and 74 RCTs with 9076 participants were included in the meta-analysis. Included studies presented data from 21 countries and 9 ERAS-guided surgical procedures with 15 (20.3%) having a low risk of bias. The mean (SD) Reporting on ERAS Compliance, Outcomes, and Elements Research checklist score was 13.5 (2.3). Hospital length of stay decreased by 1.88 days (95% CI, 0.95-2.81 days; I2 = 86.5%; P &lt; .001) and the risk of complications decreased (risk ratio, 0.71; 95% CI, 0.59-0.87; I2 = 78.6%; P &lt; .001) in the ERAS group. Risk of readmission and mortality were not significant.Conclusions and RelevanceIn this meta-analysis, ERAS guidelines were associated with decreased hospital length of stay and complications. Future studies should aim to improve implementation of ERAS and increase the reach of the guidelines.

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Enhanced recovery after surgery protocols in functional endoscopic sinus surgery for patients with chronic rhinosinusitis with nasal polyps

Cited by 15 publications

References 20 publications

Systematic literature review of humanistic and economic burdens of chronic rhinosinusitis with nasal polyposis

Systematic literature review of humanistic and economic burdens of chronic rhinosinusitis with nasal polyposis

<p>Improved perioperative quality of life in endoscopic sinus surgery by application of enhanced recovery after surgery</p>

Enhanced Recovery After Surgery Guidelines and Hospital Length of Stay, Readmission, Complications, and Mortality

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