Changes in chronic rhinosinusitis symptoms differentially associate with improvement in general health-related quality of life

Publication date: August 2018

Source: Annals of Allergy, Asthma & Immunology, Volume 121, Issue 2

Author(s): Marlene M. Speth, Lloyd P. Hoehle, Katie M. Phillips, David S. Caradonna, Stacey T. Gray, Ahmad R. Sedaghat

Abstract

Background

Previous work has shown that the symptoms of chronic rhinosinusitis (CRS) differentially associate with decreased general health-related quality of life (QOL).

Objective

We sought to determine whether longitudinal changes in different types of CRS symptomatology lead to correspondingly different magnitude changes in general health-related QOL.

Methods

Prospective observational study of 145 patients undergoing medical management for CRS. Chronic rhinosinusitis symptom severity was measured using the 22-item Sinonasal Outcome Test (SNOT-22) and associated nasal, sleep, ear/facial discomfort, and emotional subdomains of the SNOT-22. General health-related QOL was measured using the 5-dimensional EuroQoL questionnaire's visual analog scale (EQ-5D VAS). These data were collected at 2 time points: at enrollment and at a subsequent follow-up visit within the next 2 to 6 months. Associations were sought between the changes in SNOT-22 and EQ-5D VAS.

Results

The change in SNOT-22 was associated with change in EQ-5D VAS (adjusted linear regression coefficient [β] = −0.37, 95%CI: −0.51 to −0.24, P < .001). The change in EQ-5D VAS was only associated with changes in the sleep (adjusted β = −0.42, 95% confidence interval [95%CI]: −0.81 to −0.04, P = .034) and ear/facial discomfort (adjusted β = −1.00, 95%CI: −1.89 to −0.10, P = .031) subdomains but not nasal (adjusted β = −0.12, 95%CI: −0.52 to 0.28, P = .564) or emotional (adjusted β = −0.17, 95%CI: −1.83 to 1.49, P = .840) subdomains.

Conclusion

Changes in the severity of sleep and ear/facial discomfort symptoms associate most greatly with the change in general health-related QOL that CRS patients experience during routine medical management. Reduction of these extranasal symptoms of CRS may therefore lead to the greatest improvement in general health-related QOL.

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