Sinus opacification in the intensive care unit patient.

Area of Science:

• Radiology
• Intensive Care Medicine
• Otolaryngology

Background:

• Sinus opacification in intensive care unit (ICU) patients lacks clear significance.
• Understanding baseline incidence and risk factors is crucial for this population.

Purpose of the Study:

• Determine the baseline incidence of radiographic sinus abnormalities in ICU patients.
• Identify risk factors associated with the development of sinus opacification during ICU admission.

Main Methods:

• Retrospective study of 612 neurologic ICU patients.
• Analysis of head CT or MRI scans using the Lund-Mackay system (LMS).
• Exclusion of patients with prior sinus surgery, malignancy, facial fractures, or short ICU stays.

Main Results:

• 40.7% of patients had baseline sinus opacification (mean LMS 2.2).
• 42.6% experienced worsening opacification during ICU stay (mean highest LMS 4.6), peaking between days 8-10.
• Risk factors for worsening opacification included endotracheal tubes (OR 3.28), nasogastric tubes (OR 3.34), and longer length of stay (OR 2.50). Age >60 was protective (OR 0.57).

Conclusions:

• High baseline incidence of sinus opacification observed in ICU patients.
• Prolonged length of stay, younger age, and presence of nasogastric or endotracheal tubes correlate with worsening sinus opacification.
• Findings highlight the need for monitoring sinus health in critically ill patients.