功能性內視鏡鼻竇手術醫療品質評估指標

Quality-of-care Indicators for Functional Endoscopic Sinus Surgery

黃子晉(Tzu-Chin Huang) ； 戴志展(Chih-Jaan Tai) ； 王拔群(Pa-Chun Wang)

《中華民國耳鼻喉科醫學雜誌》 36卷6期 (2001/10) Pp. 375-382

https://doi.org/10.6286/2001.36.6.375

摘要

BACKGROUND: Outcome management of functional endoscopic sinus surgery (FESS) is attempting to improve the quality of chronic sinusitis treatment. Operation-related events, medical resource utilization, physician evaluation, and patient-based, sinus-specific health status are integral components of FESS outcome reporting. This study attempted to assess the feasibility of a result-oriented quality improvement program by using various outcome data as quality indicators for endoscopic sinus surgery.
METHOD: The study was conducted in a prospective, non-randomized manner. Two hundred and thirty consecutive patients undergoing FESS prospectively evaluated by CT sinus imaging and a validated Chinese version Chronic Sinusitis Survey© (CSS) before surgery. Six months after surgery, sinus-specific health status, physician evaluation, operation-related events and medical resource utilization data were collected. The effects of prognostic factors were then investigated.
RESULTS: Extent of disease was a consistent predictor (p＜0.05) for bleeding, complication occurrence, medical resource utilization, subjective sinus-specific health status and the physician’s objective evaluation of surgical outcomes. The preoperative total CSS score and the extent of disease significantly (p＜0.05) predicted the postoperative total CSS score. Subjective and objective outcomes were significantly correlated (r=0.58, p=0.001).
CONCLUSION: These findings suggest that disease severity must be stratified when FESS outcomes are reported. Results indicate that CT sinus imaging and CSS are efficient ways of generating reliable baseline information before functional endoscopic sinus surgery.

關鍵字

慢性鼻炎 ； 慢性鼻竇炎 ； 鼻竇炎 ； 慢性鼻炎及鼻竇炎 ； 功能性內視鏡鼻竇手術 ； 預後預測因子

並列摘要

BACKGROUND: Outcome management of functional endoscopic sinus surgery (FESS) is attempting to improve the quality of chronic sinusitis treatment. Operation-related events, medical resource utilization, physician evaluation, and patient-based, sinus-specific health status are integral components of FESS outcome reporting. This study attempted to assess the feasibility of a result-oriented quality improvement program by using various outcome data as quality indicators for endoscopic sinus surgery.
METHOD: The study was conducted in a prospective, non-randomized manner. Two hundred and thirty consecutive patients undergoing FESS prospectively evaluated by CT sinus imaging and a validated Chinese version Chronic Sinusitis Survey© (CSS) before surgery. Six months after surgery, sinus-specific health status, physician evaluation, operation-related events and medical resource utilization data were collected. The effects of prognostic factors were then investigated.
RESULTS: Extent of disease was a consistent predictor (p＜0.05) for bleeding, complication occurrence, medical resource utilization, subjective sinus-specific health status and the physician’s objective evaluation of surgical outcomes. The preoperative total CSS score and the extent of disease significantly (p＜0.05) predicted the postoperative total CSS score. Subjective and objective outcomes were significantly correlated (r=0.58, p=0.001).
CONCLUSION: These findings suggest that disease severity must be stratified when FESS outcomes are reported. Results indicate that CT sinus imaging and CSS are efficient ways of generating reliable baseline information before functional endoscopic sinus surgery.

並列關鍵字

chronic rhinosinusitis ； functional endoscopic sinus surgery ； outcomes predictors