Department of Otolaryngology-Head and Neck Surgery, University of Cincinnati College of Medicine, Cincinnati, USA.
Otolaryngol Head Neck Surg. 2024 Sep;171(3):708-715. doi: 10.1002/ohn.646. Epub 2024 Jan 31.
To identify predictors of chronic rhinosinusitis (CRS) in patients presenting with the chief complaint of nasal allergies.
Cross-sectional study.
Tertiary care, academic center.
Clinical and demographic characteristics were collected from participants who were patients presenting with the chief complaint of nasal allergies. From all participants, a 22-item Sinonasal Outcome Test (SNOT-22) was collected, and a modified Lund-Kennedy endoscopy score was calculated from nasal endoscopy. Association was sought between having CRS and variables of clinical and demographic characteristics, SNOT-22, and endoscopy score.
A total of 219 patients were recruited and 91.3% were diagnosed with allergic rhinitis; 45.2% were also diagnosed with CRS. Approximately half of the patients with CRS reported no intranasal corticosteroid usage. Having CRS was associated with male sex (odds ratio [OR] = 2.29, 95% confidence interval [CI]: 1.30-4.04, P = .004), endoscopy score (OR = 1.96, 95% CI: 1.59-2.42, P < .001), and the SNOT-22 nasal subdomain score (OR = 1.07, 95% CI: 1.03-1.11, P = .001) related to SNOT-22 items: "need to blow nose," "thick nasal discharge," "sense of taste/smell," and "blockage/congestion of nose." At least moderate (item score ≥3) "blockage/congestion of nose" or "thick nasal discharge," mild "need to blow nose" (item score ≥2) or very mild decreased "sense of taste/smell" (item score ≥1), and any nasal endoscopy findings (endoscopy score ≥1) were statistically significant predictors of CRS.
Moderate or more severe nasal obstruction or discharge symptoms, any decreased sense of smell/taste, or positive nasal endoscopy findings in patients believing they have allergic rhinitis should prompt further evaluation of CRS to avoid delays in treatment.
确定以鼻过敏主诉就诊的患者中慢性鼻-鼻窦炎（CRS）的预测因素。
横断面研究。
三级保健、学术中心。
收集以鼻过敏主诉就诊的患者的临床和人口统计学特征。对所有参与者收集 22 项鼻-鼻窦结局测试（SNOT-22），并从鼻内镜检查中计算改良的 Lund-Kennedy 内镜评分。寻找有 CRS 与临床和人口统计学特征、SNOT-22 和内镜评分变量之间的关联。
共招募了 219 名患者，91.3% 被诊断为过敏性鼻炎；45.2% 还被诊断为 CRS。约一半的 CRS 患者未使用鼻内皮质类固醇。患有 CRS 与男性（优势比[OR] = 2.29，95%置信区间[CI]：1.30-4.04，P = .004）、内镜评分（OR = 1.96，95% CI：1.59-2.42，P < .001）和 SNOT-22 鼻腔子域评分（OR = 1.07，95% CI：1.03-1.11，P = .001）相关，SNOT-22 项目包括：“需要擤鼻”、“浓稠的鼻分泌物”、“味觉/嗅觉”和“鼻塞/鼻充血”。至少中度（项目评分≥3）“鼻塞/鼻充血”或“浓稠的鼻分泌物”、轻度“需要擤鼻”（项目评分≥2）或非常轻度的“味觉/嗅觉减退”（项目评分≥1），以及任何鼻内镜检查结果（内镜评分≥1）均为 CRS 的统计学显著预测因素。
在认为自己患有过敏性鼻炎的患者中，中度或更严重的鼻阻塞或分泌物症状、任何嗅觉/味觉减退或阳性鼻内镜检查结果均应促使进一步评估 CRS，以避免治疗延误。
