Chronic Rhinosinusitis Patients With and Without Polyps Experience Different Symptom Perception and Quality of Life Burdens

Objective We sought to determine if chronic rhinosinusitis (CRS) patients with nasal polyps (CRSwNP) differentially perceived CRS symptom burden compared to patients without nasal polyps (CRSsNP) and to what extent CRS symptom severity was associated with quality of life (QOL) and patient-reported symptom control in the 2 groups. Methods A total of 600 patients (266 CRSwNP and 334 CRSsNP) presenting with CRS were recruited. CRS symptom burden was assessed with the 22-item Sinonasal Outcome Test (SNOT-22). SNOT-22 nasal, sleep, ear/facial discomfort, and emotional subdomain scores were calculated. General health-related QOL was assessed with the visual analog scale of the 5-dimensional EuroQol questionnaire (EQ-5D VAS). Patients rated their CRS symptom control on a 5-point scale. Results SNOT-22 scores did not differ between CRSwNP (mean: 35.6) and CRSsNP (mean: 36.3). There were no differences in nasal, sleep, and emotional subdomains of the SNOT-22. CRSsNP had higher ( P = .003) ear/facial subdomain scores than CRSwNP, while CRSwNP reported greater hyposmia ( P < .001). EQ-5D VAS was significantly lower ( P = .011) in CRSsNP (mean: 68.9) compared to CRSwNP (mean: 73.2). However, CRSwNP patients reported significantly less symptom control, compared to CRSsNP, in association with nasal and emotional symptoms. Conclusion CRSwNP and CRSsNP have differences in symptom profile, effect on health-related QOL, and patient-perceived symptom control. CRSsNP experience significantly greater burden of ear/facial discomfort, while CRSwNP report greater hyposmia. Although CRSsNP reports lower general health-related QOL overall, CRSwNP patients had lower levels of CRS symptom control for every incremental increase in symptom burden suggesting greater sensitivity/intolerance to CRS symptoms.

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Association between Asthma and Chronic Rhinosinusitis Severity in the Context of Asthma Control

Otolaryngology ◽

10.1177/0194599817728920 ◽

2017 ◽

Vol 158 (2) ◽

pp. 386-390 ◽

Cited By ~ 6

Author(s):

Adam P. Campbell ◽

Katie M. Phillips ◽

Lloyd P. Hoehle ◽

Robert A. Gaudin ◽

David S. Caradonna ◽

...

Keyword(s):

Quality Of Life ◽

Chronic Rhinosinusitis ◽

Asthma Control ◽

General Health ◽

Clinical Status ◽

Asthma Control Test ◽

Health Related ◽

Act Score ◽

Snot 22

Objective Comorbid asthma is associated with decreased quality of life (QOL) in chronic rhinosinusitis (CRS). It is unclear whether this association is independent of the patients’ clinical asthma status. We therefore sought to determine if asthma is associated with lower QOL in CRS, independent of asthma control. Study Design Cross-sectional cohort study of 350 patients with CRS. Setting Tertiary academic rhinology clinic. Subjects and Methods In total, 350 participants with CRS were recruited and 28.3% were asthmatic. CRS-specific QOL was measured using the 22-item Sinonasal Outcome Test (SNOT-22). Asthma control was assessed with the Asthma Control Test (ACT). General health-related QOL was assessed with the EuroQoL 5-dimensional general health-related quality of life survey visual analog scale (EQ-5D VAS). Associations were sought between SNOT-22 and EQ-5D VAS (dependent variables) and asthma (independent variable), while controlling for ACT. ACT score for patients with CRS without asthma was set at 25 (indicating completely controlled, asymptomatic asthma). Results Comorbid asthma was associated with SNOT-22 (β = 11.8; 95% confidence interval [CI], 6.2-17.3; P < .001) and EQ-5D VAS (β = −6.2; 95% CI, −11.2 to −1.3; P = .014). After controlling for ACT, asthma was no longer associated with SNOT-22 ( P = .147) or EQ-5D VAS ( P = .994). Instead, ACT score was associated with SNOT-22 (β = −2.1; 95% CI, −3.2 to −1.1; P < .001) and EQ-5D VAS (β = 2.1; 95% CI, 1.1 to 3.0; P < .001). ACT score completely drove the association between asthma and worse QOL. Conclusion Comorbid asthma is not necessarily reflective of decreased QOL in CRS. The association of comorbid asthma with lower QOL in CRS is related to the clinical status (eg, control) of asthma.

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Association between Symptoms of Allergic Rhinitis with Decreased General Health–Related Quality of Life

American Journal of Rhinology and Allergy ◽

10.2500/ajra.2017.31.4444 ◽

2017 ◽

Vol 31 (4) ◽

pp. 235-239 ◽

Cited By ~ 22

Author(s):

Lloyd P. Hoehle ◽

Marlene M. Speth ◽

Katie M. Phillips ◽

Robert A. Gaudin ◽

David S. Caradonna ◽

...

Keyword(s):

Quality Of Life ◽

Allergic Rhinitis ◽

Nasal Obstruction ◽

General Health ◽

Persistent Allergic Rhinitis ◽

Health Related Qol ◽

Health Related ◽

The Impact ◽

Snot 22

Background The impact of specific allergic rhinitis symptoms on patient quality of life (QOL) is currently unknown. Objective In this study, we sought to determine the association between nasal and extranasal symptoms of allergic rhinitis with general health–related QOL. Methods A total of 150 participants with ages > 18 years and persistent allergic rhinitis were prospectively recruited for this cross-sectional study. General health–related QOL was measured by using the visual analog scale (VAS) from the five-dimension EuroQol QOL survey (EQ-5D). The severity of nasal and extranasal symptoms was measured by using the 22-item Sino-Nasal Outcome Test (SNOT-22). The severity of nasal obstruction was measured by using the Nasal Obstruction Severity Evaluation (NOSE) scale. Each participant also completed a Rhinitis Control Assessment Test (RCAT). Results The total SNOT-22 score was significantly correlated with RCAT (r = -0.68 [95% confidence interval {CI}, -0.75 to -0.58]; p < 0.001) and EQ-5D VAS (r = -0.44 [95% CI, -0.56 to -0.30]; p < 0.001). Of the 22 symptoms assessed on the SNOT-22, sleep-related symptoms, and otologic symptoms were associated with the greatest decrease in general health–related QOL. Nasal symptoms were least associated with general health–related QOL. The symptom of nasal obstruction was not at all associated with general health–related QOL (p = 0.267). We confirmed this finding by showing no significant correlation between the NOSE score and EQ-5D VAS (r = -0.05 [95% CI, -0.21 to 0.12]; p = 0.582). Conclusion Sleep and otologic symptoms were associated with the greatest negative impact on QOL in adults with persistent allergic rhinitis and should be routinely assessed in their clinical evaluation.

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Health-Related Quality of Life Impairment Among Patients With Severe Chronic Rhinosinusitis With Nasal Polyps in the SINUS-24 Trial

Journal of Allergy and Clinical Immunology ◽

10.1016/j.jaci.2020.12.485 ◽

2021 ◽

Vol 147 (2) ◽

pp. AB133

Author(s):

Jorge Maspero ◽

Carl Philpott ◽

Peter Hellings ◽

Claire Hopkins ◽

Martin Wagenmann ◽

...

Keyword(s):

Quality Of Life ◽

Chronic Rhinosinusitis ◽

Nasal Polyps ◽

Health Related Quality ◽

Related Quality ◽

Health Related

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Mepolizumab Improves Health Related Quality of Life for Patients with Chronic Rhinosinusitis with Nasal Polyps: Data from the SYNAPSE study

Journal of Allergy and Clinical Immunology ◽

10.1016/j.jaci.2020.12.458 ◽

2021 ◽

Vol 147 (2) ◽

pp. AB125

Author(s):

Stella Lee ◽

Maggie Tabberer ◽

Andrew Trigg ◽

Joseph Han ◽

Wytske Fokkens ◽

...

Keyword(s):

Quality Of Life ◽

Chronic Rhinosinusitis ◽

Nasal Polyps ◽

Health Related Quality ◽

Related Quality ◽

Health Related

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Are There Gender Differences in Outcomes after the Cox-Maze Procedure for Atrial Fibrillation?

Innovations Technology and Techniques in Cardiothoracic and Vascular Surgery ◽

10.1097/imi.0b013e3182a2306c ◽

2013 ◽

Vol 8 (3) ◽

pp. 190-198 ◽

Cited By ~ 10

Author(s):

Linda Henry ◽

Sharon Hunt ◽

Sari D. Holmes ◽

Lisa M. Martin ◽

Niv Ad

Keyword(s):

Quality Of Life ◽

Atrial Fibrillation ◽

General Health ◽

Symptom Burden ◽

Maze Procedure ◽

Health Related Quality ◽

Surgical Ablation ◽

Related Quality ◽

Health Related

Objective Atrial fibrillation (AF) management suggests that women do not tolerate medication rhythm control strategies as well as men do; however, AF percutaneous catheter ablation has been found to be favorable. The study purpose was to compare the sex-based outcomes for patients who undergo the Cox-Maze procedure for AF. Methods Data were collected through our AF surgical ablation registry. Rhythm was verified by electrocardiogram and 24-hour holter at 6 and 12 months. General health-related quality of life (Short-Form 12) and specific AF symptom burden (Atrial Fibrillation Symptom Checklist: Frequency and Severity, version 3) were obtained at baseline and 12 months. Results Since 2005, a total of 540 patients have undergone a Cox-Maze procedure (34% were women). The women presented with higher operative risk [additive European System for Cardiac Operative Risk Evaluation (EuroSCORE), 6.71 ± 2.61 vs 5.25 ± 2.80, t = 5.85, P < 0.001], higher rates of congestive heart failure (49% vs 32%, P < 0.001), and more concomitant mitral valve procedures (32% vs 19%, P = 0.001). Perioperative outcomes were similar. Return to sinus rhythm off antiarrhythmics were not different at 6 and 12 months (78% vs 75%, P = 0.53, and 81% vs 80%, P = 1.00, respectively). Cumulative 2-year survival (93.9% for the men and 89.3% for the women) was not different for all-cause mortality (hazard ratio, 1.47; confidence interval, 0.68–3.21; P = 0.33) and cardiac-related mortality [women: 10/14 (71%) vs men 7/11 (64%), P = 1.00]. Health-related quality of life showed significant improvement; AF symptoms significantly decreased across the sexes. Conclusions Outcomes after the Cox-Maze procedure are similar across sex. Atrial fibrillation surgical ablation should be considered a treatment option for women—it is safe and effective, improves general health-related quality of life, and reduces AF symptom burden.

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Foot Arch Height and Quality of Life in Adults: A Strobe Observational Study

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph15071555 ◽

2018 ◽

Vol 15 (7) ◽

pp. 1555 ◽

Cited By ~ 8

Author(s):

Daniel López-López ◽

Juan Vilar-Fernández ◽

Gonzalo Barros-García ◽

Marta Losa-Iglesias ◽

Patricia Palomo-López ◽

...

Keyword(s):

Quality Of Life ◽

General Health ◽

Arch Height ◽

Foot Health ◽

Foot Structure ◽

Significant Difference ◽

Health Related Qol ◽

Health Related ◽

Foot Arch

Background: Variations in the foot structure related with the high or low arch are identified common lower limb conditions, and it is supposed to be the effect on the quality of life (QoL) associated to foot health in adults. Here we aimed to determine the relationships between relatively high and low feet arches and QoL. Methods: A cross-sectional study was carried out. Among 138 adults enrolled in the study, 66 had a high arch, 21 had a low arch, and 51 were within the normal range. Changes related to the foot structure were analyzed using Area Calc version 2.6 software, and data obtained using the Foot-Health-Status-Questionnaire (FHSQ), whose domains were compared between foot arch groups by means of the one-way analysis of variance (ANOVA). Results: The results of the FHSQ comparison between the three groups within the sample population did not show any statistically significant difference (p > 0.05) for any domains of specific foot (pain, function, general health and footwear) and general (general health, physical activity, social function and vigor) health-related QoL. Conclusions: Specific foot and general health-related QoL did not seem to be influenced by the foot arch height between high, normal and low feet arches heights. Nevertheless, further studies with higher sample sizes and matched-paired groups should be carried out.

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Comorbidities Known to Affect Physical Function Negatively Impact Baseline Health-Related Quality-of-Life in Patients With Chronic Rhinosinusitis

American Journal of Rhinology and Allergy ◽

10.1177/19458924211013610 ◽

2021 ◽

pp. 194589242110136

Author(s):

Amarbir S. Gill ◽

Shaelene Ashby ◽

Gretchen M. Oakley ◽

Toby O. Steele ◽

Dennis Menjivar ◽

...

Keyword(s):

Quality Of Life ◽

Physical Function ◽

Chronic Rhinosinusitis ◽

Health Related Quality ◽

Medical Comorbidities ◽

Related Quality ◽

Health Related ◽

The Impact ◽

Snot 22

Background Medical comorbidities are commonly encountered in chronic rhinosinusitis (CRS) and may impact both physical function and patient reported health-related quality-of-life (HRQOL). The functional comorbidity index (FCI) is designed to elucidate the role of comorbidities on functional prognosis. The objective of this study was to understand the impact of comorbidities known to impact physical function on baseline HRQOL using the FCI. Methodology: Patients meeting diagnostic criteria for CRS were prospectively enrolled in a cross-sectional study. Responses from the Sinonasal Outcomes Test-22 (SNOT-22), a measure of patient HRQOL, as well as the Lund-Kennedy and Lund-Mackay scores were recorded at enrollment. FCI was calculated retrospectively using the electronic medical record. Information was collected and compared for patients without (CRSsNP) and with nasal polyps (CRSwNP) using chi-square and t-tests. Spearman’s correlations, followed by multivariate regression analysis, were used to assess the association between FCI and SNOT-22 scores. Results One hundred and three patients met inclusion criteria for analysis. There were no significant differences in age, gender, and SNOT-22 scores between patients with CRSsNP and those with CRSwNP. FCI was significantly and independently associated with worse SNOT-22 scores ( P = .012). FCI did not correlate with endoscopy and computed tomography scores. The mean FCI for patients with CRSsNP and CRSwNP was 2.02 and 2.24, respectively, and did not differ significantly between the two cohorts ( P = .565). Conclusions Major medical comorbidities known to affect physical function are associated with worse SNOT-22 scores in patients with CRS as measured by the FCI.

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