A case-control study of medical, psychological and socio-economic factors influencing the severity of chronic rhinosinusitis

Abstract

Background: Chronic rhinosinusitis (CRS) is a common and debilitating disorder. Little is known about the epidemiology of this disease. The aims of the study were to identify differences in socio-economic variables and quality of life between patients with chronic rhinosinusitis and healthy controls, to identify any significant associations between CRS and other medical co-morbidities, psychiatric disease or environmental exposure and to explore the experience of CRS from the perspective of CRS sufferers.Methods: Participants were recruited from ENT clinics from 30 centres across the UK. They completed a study-specific questionnaire considering environmental, medical and socio-economic factors, and SF-36 and SNOT-22 scores. All participants with CRS were diagnosed by a clinician and categorised as having CRS (with polyposis, without polyposis or allergic fungal rhinosinusitis (AFRS)). Controls included family and friends of those attending ENT outpatient clinics and hospital staff who had no diagnosis of nose or sinus problems and had not been admitted to hospital in the previous 12 months. Results:A total of 1470 study participants (1249 patients and 221 controls) were included in the final analysis. Highly significant differences were seen in generic and disease-specific quality of life scores between CRS sufferers and controls; mean SNOT-22 score 45.0 for CRS compared with 12.1 amongst controls. There were no clear differences in socioeconomic variables including social class, index of multiple deprivation and educational attainment between cases and controls. Common comorbidities with a clear association included respiratory and psychiatric disorders, with a higher frequency of reported upper respiratory tract infections.Conclusions: CRS is associated with significant impairment in quality of life and with certain medical co-morbidities. In contrast to other common ENT disorders, no socioeconomic differences were found between patients and controls in this study.

Health utility reporting in chronic rhinosinusitis patients

“…These study data are useful in two ways: firstly, it provides a reference generic QOL measurement in UK patients with CRS for future researchers. We have shown the mean SNOT‐22 scores to be in line with a large UK epidemiological study, and hence, the data provided here can be used as a benchmark for future patient cohorts. Additionally, they allow comparison of CRSsNPs with other chronic disease states, the health index scores obtained from the EQ‐5D data indicate it has a significant impact on patients.…”

Patient‐reported signs of dampness at home may be a risk factor for chronic rhinosinusitis: A cross‐sectional study

“…In the present study, there was a significant association between smoking and CRS. This is in accordance with the results from some studies, although no such association was found in a recent case‐control study with objectively verified CRS . There are still few studies on the effect of environmental factors on CRS, but there are some results indicating that air pollution, the use of woodstoves as principal source of heat and exposure to gas, fumes and dust at work may be related to an increased risk of CRS .…”

Nasal and sinus symptoms and chronic rhinosinusitis in a population-based sample

“…However, a study by Philpott and colleagues of CRS patients from specialty clinics found no association between CRS and social class, index of multiple deprivation, and education. [29] Surrogate measures of SES (i.e. Medical Assistance and income) are not always interchangeable, possibly accounting for conflicting findings.…”