[A new scoring system for assessing the severity of adult acute rhinosinusitis]

Treating acute rhinosinusitis requires assessing severity and selecting appropriate antimicrobial agents. In 2006, we developed clinical scoring system for diagnosing and treating acute rhinosinusitis based on three clinical symptoms of rhinorrhea, fever, and facial pain and three nasal findings of characteristics and nasal discharge amount, nasal mucosal swelling and nasal mucosal redness. To verify and update scoring, we studied score-based diagnosis of adult acute rhinosinusitis severity. Prevalence of symptoms such as fever and serous nasal discharge in 95 subjects was low as 8.4% and 3% indicating less useful as evaluation items on the diagnosis. Mucopurulent nasal discharge (r = 0.67), facial pain (r = 0.51), rhinorrhea (r = 0.47), and swelling (r = 0.45) correlated significantly with severity evaluated by attending otolaryngological specialists. Nasal mucosal swelling caused discrepancy between clinical scoring and specialists' assess- ment. Evaluated by multivaliate analysis, factors affecting severity assessment were mucopurulent nasal discharge, facial pain, and rhinorrhea (p < 0.0001), but not swelling (p = 0.49). We concluded that mucopurulent nasal discharge scored 0, 2, or 4, facial pain scored 0, 1, or 2, and rhinorrhea scored 0, 1, or 2 should be used in evaluation in new clinical scoring, classified by severity as mild scored 1-3, moderate scored 4-6, and severe scored 7-8 by evaluating consistency with specialist assessment.