Fatigue improvement following endoscopic sinus surgery: A systematic review and meta-analysis

Alexander C. Chester, Raj Sindwani, Timothy Smith, Neil Bhattacharyya

Research output: Contribution to journalArticle

30 Citations (Scopus)

Abstract

BACKGROUND: Fatigue is a common symptom of chronic rhinosinusitis (CRS), yet the response of fatigue to endoscopic sinus surgery (ESS) has not been systematically evaluated. METHODS: Studies published in any language were retrieved by searching MEDLINE, EMBASE, Web of Science, Cochrane databases, and additional Web-based sources (from 1980-2007); by examining bibliographies of retrieved articles; and by contacting investigators in the field. Studies consisting of more than 10 adult patients analyzing the response of fatigue, vitality, energy, or malaise following ESS were included. Two authors independently evaluated studies for inclusion, rated the methods, and summarized relevant data using a standardized protocol. RESULTS: Using within-subject comparisons, 28 identified observational studies noted substantial improvement in fatigue after ESS. A subgroup analysis of 11 studies measuring outcomes using the 36-Item Short Form Health Survey (SF-36) demonstrated a moderate-sized combined effect of 0.47 (95% confidence interval, 0.38-0.56; I = 0%), corresponding to a mean ± standard deviation improvement of 9.7 ± 3.4 units on the SF-36 vitality domain scores. In studies measuring outcomes using symptom rating scores, the preoperative severity scores and improvement after surgery for fatigue were similar to the respective values for other pooled CRS symptoms. CONCLUSIONS: All 28 studies described substantial improvement in fatigue following ESS based on presurgery and postsurgery comparisons. A subgroup analysis of 11 studies reporting results by the SF-36 vitality domain scores demonstrated a moderate-sized combined effect. Preoperative fatigue severity scores and improvement noted after surgery were similar to the respective values for other pooled CRS symptoms.

Original languageEnglish (US)
Pages (from-to)730-739
Number of pages10
JournalLaryngoscope
Volume118
Issue number4
DOIs
StatePublished - Apr 2008

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Fatigue
Meta-Analysis
Outcome Assessment (Health Care)
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Health Surveys
MEDLINE
Observational Studies
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Databases
Confidence Intervals

Keywords

  • Endoscopic
  • Fatigue
  • Meta-analysis
  • Observational
  • Quality of life
  • Rhinosinusitis
  • SF-36
  • Sinus
  • Surgery
  • Systematic

ASJC Scopus subject areas

  • Otorhinolaryngology

Cite this

Fatigue improvement following endoscopic sinus surgery : A systematic review and meta-analysis. / Chester, Alexander C.; Sindwani, Raj; Smith, Timothy; Bhattacharyya, Neil.

In: Laryngoscope, Vol. 118, No. 4, 04.2008, p. 730-739.

Research output: Contribution to journalArticle

Chester, Alexander C. ; Sindwani, Raj ; Smith, Timothy ; Bhattacharyya, Neil. / Fatigue improvement following endoscopic sinus surgery : A systematic review and meta-analysis. In: Laryngoscope. 2008 ; Vol. 118, No. 4. pp. 730-739.
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abstract = "BACKGROUND: Fatigue is a common symptom of chronic rhinosinusitis (CRS), yet the response of fatigue to endoscopic sinus surgery (ESS) has not been systematically evaluated. METHODS: Studies published in any language were retrieved by searching MEDLINE, EMBASE, Web of Science, Cochrane databases, and additional Web-based sources (from 1980-2007); by examining bibliographies of retrieved articles; and by contacting investigators in the field. Studies consisting of more than 10 adult patients analyzing the response of fatigue, vitality, energy, or malaise following ESS were included. Two authors independently evaluated studies for inclusion, rated the methods, and summarized relevant data using a standardized protocol. RESULTS: Using within-subject comparisons, 28 identified observational studies noted substantial improvement in fatigue after ESS. A subgroup analysis of 11 studies measuring outcomes using the 36-Item Short Form Health Survey (SF-36) demonstrated a moderate-sized combined effect of 0.47 (95{\%} confidence interval, 0.38-0.56; I = 0{\%}), corresponding to a mean ± standard deviation improvement of 9.7 ± 3.4 units on the SF-36 vitality domain scores. In studies measuring outcomes using symptom rating scores, the preoperative severity scores and improvement after surgery for fatigue were similar to the respective values for other pooled CRS symptoms. CONCLUSIONS: All 28 studies described substantial improvement in fatigue following ESS based on presurgery and postsurgery comparisons. A subgroup analysis of 11 studies reporting results by the SF-36 vitality domain scores demonstrated a moderate-sized combined effect. Preoperative fatigue severity scores and improvement noted after surgery were similar to the respective values for other pooled CRS symptoms.",
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