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Cluster Analysis of Chronic Rhinosinusitis Suggests Gender-Based Differences.

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ORL; Journal for Oto-Rhino-Laryngology and Its Related Specialties
|November 21, 2018
PubMed
Summary

Patient-reported symptom severity, not objective measures, predicts long-term satisfaction after chronic rhinosinusitis (CRS) treatment. Pre-treatment disease severity (SNOT-22 score) is key for successful outcomes.

Keywords:
Chronic rhinosinusitisComputerized tomographyNasal polypsSino-Nasal Outcome Test 22Visual analog scale score

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Area of Science:

  • Otolaryngology
  • Rhinology
  • Medical diagnostics

Background:

  • Chronic rhinosinusitis (CRS) poses a significant burden on patients.
  • Evaluating treatment outcomes in CRS requires understanding patient-reported versus objective measures.
  • Predicting long-term patient satisfaction is crucial for effective CRS management.

Purpose of the Study:

  • To investigate the relationship between pre-treatment chronic rhinosinusitis (CRS) severity and subjective improvement after treatment.
  • To determine if objective disease indicators or subjective symptom scores better predict treatment outcomes in CRS patients.

Main Methods:

  • 97 patients with CRS underwent symptom assessment using the visual analog scale (VAS) and Sino-Nasal Outcome Test 22 (SNOT-22) concurrently with sinus CT scans.
  • Cluster analysis was performed using demographic data, polyp presence, CT findings, and VAS scores.
  • Statistical analysis identified predictors of treatment outcomes.

Main Results:

  • Three patient clusters were identified: CRS without nasal polyps (CRSsNP) in females, CRS with nasal polyps (CRSwNP), and CRSsNP in males.
  • Subjective measures, specifically the SNOT-22 score and gender, were significant predictors of treatment outcomes (p=0.005 and p=0.021, respectively).
  • Objective measures like CT scan scores were not significant predictors (p=0.26).

Conclusions:

  • Long-term patient satisfaction in chronic rhinosinusitis (CRS) is strongly linked to pre-treatment subjective symptom severity, particularly overall disease severity measured by the SNOT-22.
  • Objective disease indicators, such as CT scan results and inflammation markers, do not reliably predict patient satisfaction.
  • Focusing on subjective symptom relief is essential for improving long-term outcomes in CRS management.