Outcomes of endoscopic sinus surgery in an elderly population: comparison with those in an adult population

Objective: The aim of this study was to compare the surgical outcomes of endoscopic sinus surgery in two patient groups: adults younger than 65 years of age and adults aged 65 years or older. Design: A retrospective study. Setting: This study was conducted at an academic tertiary referral centre. Participants: One hundred and eighty consecutive older patients (>= 65 years), and 180 adult patients (> 15, < 65 years) with chronic rhinosinusitis who underwent endoscopic sinus surgery under local anaesthesia between 1997 and 2007 were enrolled in this study. Main outcome measures: Recurrence and complication rates were analyzed. Data were analyzed using the Mann-Whitney test, Fisher's Exact test, the Pearson Chi-Square test, and univariate and multivariate logistic regression. P < 0.05 was considered statistically significant. Results: When looked at without control for other factors the surgical complication rates were higher in the older group patients (31%) compared with the younger patients (11%). However, multivariate logistic regression analysis showed that preoperative duration of symptoms, length of follow-up, and diabetes mellitus were positively correlated with complications. In this analysis, the older patients, once controlled for these factors, were less likely to have complications. Regarding recurrence, in multivariate analysis there was no difference between the older and the younger group with preoperative duration and length of postoperative follow-up having a small effect. Conclusions: Comorbidity especially diabetes mellitus and duration of the condition should be the factors considered preoperatively to predict the likely hood of complications rather than whether the patient is younger or older that 65 years of age.