Department of Otolaryngology-Head and Neck Surgery, Harvard Medical School, Boston, Massachusetts, USA.
Department of Surgery, Center for Surgery and Public Health, Brigham and Women's Hospital, Boston, Massachusetts, USA.
Otolaryngol Head Neck Surg. 2023 Dec;169(6):1462-1471. doi: 10.1002/ohn.395. Epub 2023 Jun 14.
While general health may be influenced by sinonasal symptoms, their effects may be overshadowed by comorbid states which may be more serious. To assess the validity of this postulate, we measured the extent to which sinonasal symptoms and concurrent conditions influenced general health.
Observational outcomes study.
Academic medical center, community care sites.
Adults with sinonasal symptoms completed the 22-item Sinonasal Outcome Test, along with the Patient-Reported Outcomes Measurement Information System global health short form. Comorbidities were categorized with the Deyo modification of the Charlson comorbidity index. Multivariate regression analyses were utilized to determine the relative impact of sinonasal symptoms and concurrent comorbid conditions on general health.
Data from 219 consecutive patients demonstrated that sinonasal symptoms were associated with significantly diminished general physical (β = -1.431, p < .001), mental (β = -1.000, p < .001), overall (β = -1.026, p < .001), and social health (β = -0.872, p = .003), regardless of the presence of potentially life-threatening comorbid conditions. Comorbid conditions included cardiovascular disease, chronic obstructive pulmonary disease, connective tissue disease, peptic ulcer, diabetes mellitus, and hepatic disease. The effect of sinonasal symptoms was neither subsumed nor overshadowed by the effects of comorbid states. Nasal, ear, sleep, and psychological domain scores were also associated with general physical, mental, and global health while adjusting for the impact of comorbidities.
Sinonasal symptoms have a substantial effect on general health which is not subsumed by the presence of potentially life-threatening concurrent comorbidities. These data may help support the importance of funding and resource allocation for conditions causing sinonasal symptoms.
尽管一般健康状况可能受到鼻-鼻窦症状的影响，但这些症状的影响可能会被更严重的合并症所掩盖。为了评估这一假设的有效性，我们评估了鼻-鼻窦症状和同时存在的疾病对一般健康状况的影响程度。
观察性结局研究。
学术医疗中心、社区护理点。
有鼻-鼻窦症状的成年人完成了 22 项鼻-鼻窦结局测试，以及患者报告的结局测量信息系统整体健康简表。合并症使用 Dyeo 改良 Charlson 合并症指数进行分类。利用多变量回归分析来确定鼻-鼻窦症状和同时存在的合并症对一般健康的相对影响。
来自 219 名连续患者的数据表明，鼻-鼻窦症状与显著降低的一般身体（β=-1.431，p<0.001）、精神（β=-1.000，p<0.001）、整体（β=-1.026，p<0.001）和社会健康（β=-0.872，p=0.003）相关，无论是否存在潜在威胁生命的合并症。合并症包括心血管疾病、慢性阻塞性肺疾病、结缔组织疾病、消化性溃疡、糖尿病和肝脏疾病。鼻-鼻窦症状的影响既没有被合并症的影响所包含，也没有被其掩盖。在调整了合并症的影响后，鼻腔、耳朵、睡眠和心理领域的评分也与一般身体、精神和整体健康相关。
鼻-鼻窦症状对一般健康状况有显著影响，这一影响不受潜在威胁生命的合并症的影响。这些数据可能有助于支持为导致鼻-鼻窦症状的疾病提供资金和资源分配的重要性。
