Department of Otolaryngology, Harvard Medical School, Boston, MA.
Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Boston, MA.
Int Forum Allergy Rhinol. 2017 Oct;7(10):945-951. doi: 10.1002/alr.21992. Epub 2017 Jul 28.
Patient-reported control of chronic rhinosinusitis (CRS) symptoms is associated with the quality of life impact of CRS. We sought to determine if 22-item Sino-Nasal Outcome Test (SNOT-22) score is predictive of patient-perceived CRS symptom control.
Prospective cross-sectional study of 202 patients with CRS. Participants were asked to rate their CRS symptom control as "not at all," "a little," "somewhat," "very," and "completely." The severity of patient CRS symptomatology was measured using the SNOT-22. The relationship between SNOT-22 score and patient-reported CRS symptom control was determined using regression, analysis of variance (ANOVA), and receiver operating characteristic (ROC) curve analysis.
SNOT-22 was negatively associated with patient-reported CRS symptom control (adjusted β = -0.03; 95% CI, -0.04 to -0.02; p < 0.001), after controlling for demographic and clinical characteristics. There was a significant difference in SNOT-22 scores of participants reporting each level of symptom control (p < 0.001) with the greatest differences between participants who rated their CRS symptom control as "not at all," "a little," and "somewhat," which we deem poor CRS symptom control, and the group who described their level of CRS symptom control described as "very" and "completely," which we deem well-controlled CRS symptoms. These results were true across all SNOT-22 subdomains scores as well. Using ROC analysis, a SNOT-22 score of 35 identified patients reporting poor vs well-controlled CRS symptom control with 71.4% sensitivity and 85.5% specificity.
SNOT-22 score is associated with how well patients feel their CRS symptomatology is controlled. Moreover, SNOT-22 score can be used to accurately distinguish patients with poor vs well-controlled CRS symptoms.
患者报告的慢性鼻-鼻窦炎(CRS)症状控制与 CRS 对生活质量的影响有关。我们试图确定 22 项鼻-鼻窦结局测试(SNOT-22)评分是否可预测患者对 CRS 症状控制的感知。
对 202 例 CRS 患者进行前瞻性横断面研究。要求参与者对其 CRS 症状控制程度进行评分,分为“完全没有”“有一点”“有些”“非常”和“完全”。使用 SNOT-22 评估患者 CRS 症状的严重程度。使用回归、方差分析(ANOVA)和受试者工作特征(ROC)曲线分析确定 SNOT-22 评分与患者报告的 CRS 症状控制之间的关系。
在控制人口统计学和临床特征后,SNOT-22 与患者报告的 CRS 症状控制呈负相关(调整后的β=-0.03;95%CI,-0.04 至-0.02;p<0.001)。报告每个症状控制水平的参与者的 SNOT-22 评分存在显著差异(p<0.001),在将 CRS 症状控制评为“完全没有”“有一点”和“有些”的患者与将 CRS 症状控制评为“非常”和“完全”的患者之间存在较大差异,我们将后者视为 CRS 症状控制良好,而将前者视为 CRS 症状控制较差。这些结果在所有 SNOT-22 子域评分中均成立。使用 ROC 分析,SNOT-22 评分为 35 分可识别报告 CRS 症状控制不佳与控制良好的患者,其敏感性为 71.4%,特异性为 85.5%。
SNOT-22 评分与患者对 CRS 症状控制的自我感觉相关。此外,SNOT-22 评分可用于准确区分 CRS 症状控制不佳与控制良好的患者。