Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA.
Department of Otolaryngology-Head and Neck Surgery, NewYork-Presbyterian/Columbia University Irving Medical Center, New York, NY, USA.
Ann Otol Rhinol Laryngol. 2022 Aug;131(8):817-823. doi: 10.1177/00034894211045636. Epub 2021 Sep 11.
Appropriate management of chronic rhinosinusitis (CRS) among patients with cystic fibrosis (CF) is important in improving quality of life. Otolaryngologists play a critical role in reducing CRS symptom burden. This study seeks to evaluate the role of patient-reported quality-of-life measures in guiding interventions for CF-related sinus disease.
We performed a prospective, cross-sectional study of 105 patients presenting to a CF-accredited clinic between July and September 2018. Demographic data and sinus surgery history were collected, in addition to Sino-Nasal Outcome Test (SNOT-22) and Questionnaire of Olfactory Disorders (QOD-NS) scores. Statistical analysis was conducted using correlation and non-parametric Mann-Whitney tests.
Baseline well-care visits accounted for 71.4% of all clinical evaluations. Prior otolaryngology intervention was noted in 69 (66%) patients, where the majority of these patients (63/69; 91%) underwent endoscopic sinus surgery (ESS). Patients with a history of otolaryngology intervention had an average SNOT-22 score of 33.2 (SD = 20.6) compared to 24.9 (SD = 18.5) for patients without prior intervention ( = .048). The average QOD-NS score was 5.5 (SD = 6.4) among patients referred to otolaryngologists and 3.1 (SD = 5.7) for non-referred patients ( = .012). SNOT-22 and QOD-NS scores were modestly correlated ( of .43).
CF patients with symptoms resulting in worse quality-of-life assessments were more likely to have established coordinated care with an otolaryngologist. Further validation of the utility of SNOT-22 and QOD-NS questionnaires as care coordination metrics is necessary in the CF population.
在囊性纤维化(CF)患者中,对慢性鼻-鼻窦炎(CRS)进行适当的管理对于提高生活质量非常重要。耳鼻喉科医生在减轻 CRS 症状负担方面发挥着关键作用。本研究旨在评估患者报告的生活质量测量在指导 CF 相关鼻窦疾病干预中的作用。
我们对 2018 年 7 月至 9 月期间在 CF 认证诊所就诊的 105 例患者进行了前瞻性、横断面研究。收集了人口统计学数据和鼻窦手术史,以及 Sino-Nasal Outcome Test(SNOT-22)和嗅觉障碍问卷(QOD-NS)评分。使用相关性和非参数 Mann-Whitney U 检验进行统计分析。
基线常规护理就诊占所有临床评估的 71.4%。在 69 例(66%)患者中注意到耳鼻喉科干预,其中大多数患者(63/69;91%)接受了内镜鼻窦手术(ESS)。有耳鼻喉科干预史的患者 SNOT-22 评分为 33.2(SD=20.6),而无干预史的患者为 24.9(SD=18.5)(=0.048)。转至耳鼻喉科的患者 QOD-NS 评分为 5.5(SD=6.4),未转至耳鼻喉科的患者为 3.1(SD=5.7)(=0.012)。SNOT-22 和 QOD-NS 评分呈中度相关(r=0.43)。
因症状导致生活质量评估较差的 CF 患者更有可能与耳鼻喉科医生建立协调护理关系。需要进一步验证 SNOT-22 和 QOD-NS 问卷作为 CF 人群护理协调指标的实用性。