Predictors of Quality-of-Life Improvements Following Global Head and Neck Surgery Trips to Underserved Regions

Bharat A Panuganti; Aria Jafari; Sarek Shen; Jesse R Qualliotine; Elizabeth A Schueth; Bruce Campbell; Henry Ngoitsi; Susan Cordes

doi:10.1002/lary.29522

Predictors of Quality-of-Life Improvements Following Global Head and Neck Surgery Trips to Underserved Regions

Laryngoscope. 2021 Sep;131(9):2006-2010. doi: 10.1002/lary.29522. Epub 2021 Mar 18.

Authors

Bharat A Panuganti¹, Aria Jafari², Sarek Shen³, Jesse R Qualliotine¹, Elizabeth A Schueth⁴, Bruce Campbell⁵, Henry Ngoitsi⁶, Susan Cordes³

Affiliations

¹ Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of California-San Diego, San Diego, California, U.S.A.
² Division of Rhinology and Endoscopic Skull Base Surgery, Department of Otolaryngology-Head and Neck Surgery, University of Washington, Seattle, Washington, U.S.A.
³ Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University, Baltimore, Maryland, U.S.A.
⁴ Department of Otolaryngology, Indiana University School of Medicine, Indianapolis, Indiana, U.S.A.
⁵ Department of Otolaryngology and Communication Sciences, Medical College of Wisconsin, Milwaukee, Wisconsin, U.S.A.
⁶ Moi Teaching and Referral Hospital, Moi University School of Medicine, Eldoret, Kenya.

PMID: 33734447
DOI: 10.1002/lary.29522

Abstract

Objectives/hypothesis: To conduct longitudinal postoperative follow-up and discern health-related quality-of-life (HR-QoL) changes using a validated questionnaire among patients undergoing head and neck surgeries during a short-term, global surgical trip in a resource-limited setting. To identify clinicodemographic predictors of post-operative HR-QoL improvements in this setting.

Study design: Retrospective observational study with prospective follow-up.

Methods: Patients undergoing surgery at Moi Teaching and Referral Hospital in Eldoret, Kenya through the authors' short-term surgical trip (STST) between 2016 and 2019 were asked to complete preoperative Short Form-36 (SF-36) HR-QoL questionnaires, and postoperative SF-36 questionnaires during subsequent follow-up. Preoperative and postoperative SF-36 domain scores, and two composite scores (mental component summary [MCS] and physical component summary [PCS]) were compared. Linear regression models were fit to identify clinicodemographic factors predictors of general health (GH), MCS, and PCS scores.

Results: Among the 26 participating patients, significant improvements were seen in post-operative GH (mean change = 19.8) and MCS (mean change = 11.2) scores. Lower pre-operative GH, MCS, and PCS scores were predictive of greater improvement in the corresponding post-operative scores. Longer time to follow-up was associated with greater improvement in GH score. Mean follow-up interval was 23.1 months (SD = 1.8 months).

Conclusions: Utilizing the SF-36 questionnaire, we found that patients' perception of their general and psychosocial health improved after undergoing head and neck surgeries through a global STST. This study provides important, preliminary evidence that that elective surgeries performed in low-resource settings convey substantial benefit to patient QoL.

Level of evidence: 4 Laryngoscope, 131:2006-2010, 2021.

Keywords: Short-term surgical trip; head and neck surgery; health-related quality-of-life.

Publication types

Comparative Study
Observational Study

MeSH terms

Adult
Cost-Benefit Analysis
Female
Follow-Up Studies
Head and Neck Neoplasms / surgery*
Humans
Kenya / epidemiology
Linear Models
Male
Medically Underserved Area*
Otolaryngologists / statistics & numerical data
Otorhinolaryngologic Diseases / surgery*
Postoperative Complications / epidemiology
Postoperative Complications / psychology
Predictive Value of Tests
Prospective Studies
Quality of Life / psychology*
Retrospective Studies
Safety
Surveys and Questionnaires / statistics & numerical data*