Katie M Phillips1,2, Eric Barbarite1,2, Lloyd P Hoehle3, David S Caradonna1,4, Stacey T Gray1,2, Ahmad R Sedaghat5. 1. Department of Otolaryngology, Harvard Medical School, Boston, Massachusetts, USA. 2. Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA. 3. Edward Via College of Osteopathic Medicine-Carolinas, Spartanburg, South Carolina, USA. 4. Division of Otolaryngology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA. 5. Department of Otolaryngology-Head and Neck Surgery, College of Medicine, University of Cincinnati, Cincinnati, Ohio, USA.
Abstract
OBJECTIVE: Acute exacerbation of chronic rhinosinusitis (AECRS) is associated with significant quality-of-life decreases. We sought to determine characteristics associated with an exacerbation-prone phenotype in chronic rhinosinusitis (CRS). STUDY DESIGN: Cross-sectional. SETTING: Tertiary care rhinology clinic. SUBJECTS: Patients with CRS (N = 209). METHODS: Patient-reported number of sinus infections, CRS-related antibiotics, and CRS-related oral corticosteroids taken in the last 12 months were used as metrics for AECRS frequency. Sinonasal symptom burden was assessed with the 22-item Sinonasal Outcome Test (SNOT-22). Ninety patients reporting 0 for all AECRS metrics were considered to have had no AECRS in the prior 12 months. A total of 119 patients reported >3 on at least 1 AECRS metric and were considered as having an exacerbation-prone phenotype. Characteristics associated with patients with an exacerbation-prone phenotype were identified with exploratory regression analysis. RESULTS: An exacerbation-prone phenotype was positively associated with comorbid asthma (adjusted odds ratio [ORadj] = 3.68, 95% CI: 1.42-9.50, P = .007) and SNOT-22 (ORadj = 1.06, 95% CI: 1.04-1.09, P < .001). Polyps were negatively associated (ORadj = 0.27, 95% CI: 0.11-0.68, P = .005) with an exacerbation-prone phenotype. SNOT-22 score ≥24 identified patients with an exacerbation-prone phenotype with a sensitivity of 93.3% and a specificity of 57.8%. Having either a SNOT-22 score ≥24 with a nasal subdomain score ≥12 or a SNOT-22 score ≥24 with an ear/facial discomfort subdomain score ≥3 provided >80% sensitivity and specificity for detecting patients prone to exacerbation. CONCLUSIONS: In total, these results point to a CRS exacerbation-prone phenotype characterized by high sinonasal disease burden with comorbid asthma but interestingly without polyps.
OBJECTIVE: Acute exacerbation of chronic rhinosinusitis (AECRS) is associated with significant quality-of-life decreases. We sought to determine characteristics associated with an exacerbation-prone phenotype in chronic rhinosinusitis (CRS). STUDY DESIGN: Cross-sectional. SETTING: Tertiary care rhinology clinic. SUBJECTS:Patients with CRS (N = 209). METHODS:Patient-reported number of sinus infections, CRS-related antibiotics, and CRS-related oral corticosteroids taken in the last 12 months were used as metrics for AECRS frequency. Sinonasal symptom burden was assessed with the 22-item Sinonasal Outcome Test (SNOT-22). Ninety patients reporting 0 for all AECRS metrics were considered to have had no AECRS in the prior 12 months. A total of 119 patients reported >3 on at least 1 AECRS metric and were considered as having an exacerbation-prone phenotype. Characteristics associated with patients with an exacerbation-prone phenotype were identified with exploratory regression analysis. RESULTS: An exacerbation-prone phenotype was positively associated with comorbid asthma (adjusted odds ratio [ORadj] = 3.68, 95% CI: 1.42-9.50, P = .007) and SNOT-22 (ORadj = 1.06, 95% CI: 1.04-1.09, P < .001). Polyps were negatively associated (ORadj = 0.27, 95% CI: 0.11-0.68, P = .005) with an exacerbation-prone phenotype. SNOT-22 score ≥24 identified patients with an exacerbation-prone phenotype with a sensitivity of 93.3% and a specificity of 57.8%. Having either a SNOT-22 score ≥24 with a nasal subdomain score ≥12 or a SNOT-22 score ≥24 with an ear/facial discomfort subdomain score ≥3 provided >80% sensitivity and specificity for detecting patients prone to exacerbation. CONCLUSIONS: In total, these results point to a CRS exacerbation-prone phenotype characterized by high sinonasal disease burden with comorbid asthma but interestingly without polyps.
Authors: Jelle L P van Gurp; Liza G G van Lent; Nicole Stoel; Carin C D van der Rijt; Maja J A de Jonge; Saskia M Pulleman; Julia C M van Weert; Jeroen Hasselaar Journal: Support Care Cancer Date: 2022-06-08 Impact factor: 3.359
Authors: David T Liu; Martin Schally; Sven Schneider; Julia Eckl-Dorna; Katie M Phillips; Christian A Mueller; Ahmad R Sedaghat; Gerold Besser Journal: Eur Arch Otorhinolaryngol Date: 2021-04-20 Impact factor: 2.503