Lim Subin, Trotier Daniel, Karpov Matvey, Han Joseph, Lam Kent
Department of Otolaryngology - Head and Neck Surgery, Eastern Virginia Medical School, Norfolk, VA, USA.
Medical College of Wisconsin, Milwaukee, WI, USA.
Am J Rhinol Allergy. 2025 Mar;39(2):128-135. doi: 10.1177/19458924241312318. Epub 2025 Jan 9.
The Sino-nasal Outcome Test (SNOT-22) is a 22-question survey that is utilized to evaluate health-related quality of life of patients with chronic rhinosinusitis (CRS). The Patient Global Impression Symptom Severity (PGISS) is a similar yet versatile instrument that combines features of both a Likert scale and a visual analog to assess symptom severity in CRS patients. While previous studies have evaluated the validity of SNOT-22 as an instrument to measure CRS patients' symptom severity, no studies have evaluated PGISS scale's ability to evaluate and guide treatment plans for CRS patients.
The primary objective of this study was to analyze the clinical utility of PGISS in assessing subjective symptom severity and objective disease status in CRS patients. We additionally aimed to investigate if PGISS scores could serve as predictors for treatment strategies in CRS patients.
Electronic medical records of CRS patients were retrospectively reviewed between January 2020 and January 2021 from Eastern Virginia Medical School and Sentara Healthcare. Information on demographics, objective disease metrics, treatment, and labs were collected. Statistical analyses were conducted using SAS 9.4 software.
A total of 150 patients were included in our study. A statistically significant positive correlation was found between PGISS and SNOT-22 scores (r(131) = 0.701, < .0001). Patients with moderate to severe PGISS scores had significantly higher odds of changing their treatment course (odds ratio [OR] = 6.813, = .001, and OR = 5.491, = .018, respectively). Additionally, patients with severe PGISS scores had decreased odds of receiving biological intervention (OR = 0.048, = .043), but they had considerably higher odds of pursuing surgery (OR = 15.939, = .046). No significant associations were seen between PGISS scores and receiving topical steroids, systematic steroids, nonsteroidal medical treatment, or imaging interventions ( > .05).
Clinicians may consider using the PGISS scale as an alternative method to the SNOT-22 to evaluate subjective symptom severity and guide treatment plans for patients with CRS.
鼻窦结局测试（SNOT - 22）是一项包含22个问题的调查问卷，用于评估慢性鼻窦炎（CRS）患者与健康相关的生活质量。患者整体印象症状严重程度（PGISS）是一种类似但用途广泛的工具，它结合了李克特量表和视觉模拟量表的特点，用于评估CRS患者的症状严重程度。虽然先前的研究评估了SNOT - 22作为测量CRS患者症状严重程度工具的有效性，但尚无研究评估PGISS量表评估和指导CRS患者治疗方案的能力。
本研究的主要目的是分析PGISS在评估CRS患者主观症状严重程度和客观疾病状态方面的临床实用性。我们还旨在研究PGISS评分是否可作为CRS患者治疗策略的预测指标。
回顾性分析了2020年1月至2021年1月期间东弗吉尼亚医学院和Sentara医疗集团的CRS患者电子病历。收集了人口统计学、客观疾病指标、治疗和实验室检查等信息。使用SAS 9.4软件进行统计分析。
本研究共纳入150例患者。发现PGISS与SNOT - 22评分之间存在显著的正相关（r(131) = 0.701，P <.0001）。中度至重度PGISS评分的患者改变治疗方案的几率显著更高（优势比[OR]分别为6.813，P =.001和OR = 5.491，P =.018）。此外，重度PGISS评分的患者接受生物干预的几率降低（OR = 0.048，P =.043），但他们接受手术的几率显著更高（OR = 15.939，P =.046）。未发现PGISS评分与接受局部类固醇、全身类固醇、非甾体类药物治疗或影像学干预之间存在显著关联（P >.05）。
临床医生可考虑使用PGISS量表作为SNOT - 22的替代方法，以评估主观症状严重程度并指导CRS患者的治疗方案。
