Department of Otolaryngology, Head and Neck Surgery, St. Olavs Hospital, 7006 Trondheim University Hospital, Norway; Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.
Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway; Department of Thoracic Medicine, St. Olavs Hospital, Trondheim University Hospital, Norway.
Respir Med. 2021 Nov-Dec;189:106661. doi: 10.1016/j.rmed.2021.106661. Epub 2021 Oct 14.
Rhinosinusitis without nasal polyps (RSsNP) is prevalent in COPD. Previous studies on its association with health-related quality of life (HRQoL) have limitations, and RSsNP is currently not recognized as a comorbidity. This study investigates HRQoL in COPD including a focus on RSsNP. Generic HRQoL was assessed with the Short Form-36 (SF-36v2) questionnaire and compared between 90 COPD and 93 control subjects and in subgroups with and without RSsNP. The association between RSsNP and COPD versus not and generic HRQoL was assessed by multivariable linear regression with adjustments for age, education, and body mass index (BMI). Disease-specific HRQoL was assessed by Sinonasal outcome test-22 (SNOT-22), St. Georges Respiratory Questionnaire (SGRQ), and COPD Assessment Test (CAT) and compared between COPD with and without RSsNP, and their association to RSsNP was assessed by multivariable linear regression with adjustments for age, BMI, and FEV% predicted. RSsNP was associated with poorer disease-specific HRQoL, with higher SNOT-22 total score (14.67 points; 95% CI, 7.06-22.28; P < .001) and psychological subscale score (3.24 points; 95% CI, 0.37-6.11; P = .03), SGRQ symptom score (13.08 points; 95% CI, 2.73-23.4; P = .014), and CAT score (4.41 points; 95% CI, 1.15-7.66; P = .009). Generic HRQoL was poorer in COPD patients than in the control subjects. In addition to COPD, concomitant RSsNP was associated with poorer physical functioning, general health, vitality, and physical component summary. RSsNP in COPD is associated with poorer disease-specific HRQoL that is clinically relevant and, as it is amenable for treatment, should be recognized as a comorbidity of COPD.
非鼻息肉性鼻窦炎（RSsNP）在 COPD 中较为常见。既往关于其与健康相关生活质量（HRQoL）的研究存在局限性，且目前 RSsNP 尚未被认为是一种合并症。本研究旨在探讨 COPD 患者的 HRQoL，尤其关注 RSsNP。采用健康调查简表 36 项（SF-36v2）问卷评估一般 HRQoL，并与 90 例 COPD 患者和 93 例对照组进行比较，同时在伴有和不伴有 RSsNP 的亚组中进行比较。采用多元线性回归分析，调整年龄、教育程度和体重指数（BMI）后，评估 RSsNP 与 COPD（有/无）和一般 HRQoL 的关系。采用鼻-鼻窦炎结局测试 22 项（SNOT-22）、圣乔治呼吸问卷（SGRQ）和 COPD 评估测试（CAT）评估疾病特异性 HRQoL，并比较伴有和不伴有 RSsNP 的 COPD 患者之间的差异，同时采用多元线性回归分析，调整年龄、BMI 和 FEV%预测值后，评估 RSsNP 与疾病特异性 HRQoL 的关系。RSsNP 与疾病特异性 HRQoL 较差相关，SNOT-22 总分（14.67 分；95%CI，7.06-22.28；P<0.001）和心理亚量表评分（3.24 分；95%CI，0.37-6.11；P=0.03）、SGRQ 症状评分（13.08 分；95%CI，2.73-23.4；P=0.014）和 CAT 评分（4.41 分；95%CI，1.15-7.66；P=0.009）均较高。与对照组相比，COPD 患者的一般 HRQoL 更差。除 COPD 外，同时伴有 RSsNP 与身体机能、一般健康、活力和生理综合评分较差相关。COPD 合并 RSsNP 与疾病特异性 HRQoL 较差相关，具有临床意义，且 RSsNP 可治疗，应被认为是 COPD 的一种合并症。
