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The impact of osteitis on disease severity measures and quality of life outcomes in chronic rhinosinusitis.

ABSTRACT: The significance of osteitis in the management of recalcitrant chronic rhinosinusitis (CRS) has yet to be clearly understood and clinical outcomes data for these patients is lacking. Osteitis has been characterized by inflammatory infiltrate, osteoneogenesis, and bony sclerosis with remodeling. In this study we sought to determine if osteitis negatively impacts quality-of-life (QOL) or clinical outcomes following endoscopic sinus surgery (ESS).A total of 190 adult patients with CRS were prospectively enrolled.Osteitis was characterized by quantifiable bony thickening on sinus computed tomography (CT). Baseline measures and postoperative outcomes were evaluated using endoscopy exam, olfactory testing, and 2 validated disease-specific QOL surveys: the Chronic Sinusitis Survey (CSS) and Rhinosinusitis Disability Index (RSDI). Bivariate and multivariate analyses were performed to evaluate differences between patients with and without osteitis.Patients with osteitis (n = 79) had higher prevalence of nasal polyposis and prior ESS (both p < 0.001) and significantly worse baseline CT, endoscopy, and olfactory scores (all p < 0.001) than patients without osteitis. There was no difference in baseline QOL scores between patients with and without osteitis. Following ESS, there were significant improvements in all QOL measures in both groups; however, patients without osteitis were more likely to exhibit clinically meaningful improvement on physical RSDI subscale scores, independent of other clinical factors (79.0% vs 62.3%; odds ratio [OR]: 3.85, p = 0.011).Osteitis is associated with worse baseline measures of disease severity and inflammation. Our data suggest that whereas patients with osteitis improve after ESS, the presence of osteitis is associated with a reduced chance of improvement in some outcome measures.

SUBMITTER: Bhandarkar ND

PROVIDER: S-EPMC3198819 | biostudies-literature | 2011 Sep-Oct

REPOSITORIES: biostudies-literature

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The impact of osteitis on disease severity measures and quality of life outcomes in chronic rhinosinusitis.

Bhandarkar Naveen D ND Mace Jess C JC Smith Timothy L TL

International forum of allergy & rhinology 20110901 5

<h4>Background</h4>The significance of osteitis in the management of recalcitrant chronic rhinosinusitis (CRS) has yet to be clearly understood and clinical outcomes data for these patients is lacking. Osteitis has been characterized by inflammatory infiltrate, osteoneogenesis, and bony sclerosis with remodeling. In this study we sought to determine if osteitis negatively impacts quality-of-life (QOL) or clinical outcomes following endoscopic sinus surgery (ESS).<h4>Methods</h4>A total of 190 ad ...[more]

PMID: 22028948

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Project description:Overview. The Centers for Disease Control and Prevention (CDC) health-related quality of life (HRQoL) indicators are widely used in the general population to determine the burden of disease, identify health needs, and direct public health policy. These indicators also allow the burden of illness to be compared across different diseases. Although Lyme disease has recently been acknowledged as a major health threat in the USA with more than 300,000 new cases per year, no comprehensive assessment of the health burden of this tickborne disease is available. This study assesses the HRQoL of patients with chronic Lyme disease (CLD) and compares the severity of CLD to other chronic conditions. Methods. Of 5,357 subjects who responded to an online survey, 3,090 were selected for the study. Respondents were characterized as having CLD if they were clinically diagnosed with Lyme disease and had persisting symptoms lasting more than 6 months following antibiotic treatment. HRQoL of CLD patients was assessed using the CDC 9-item metric. The HRQoL analysis for CLD was compared to published analyses for the general population and other chronic illnesses using standard statistical methods. Results. Compared to the general population and patients with other chronic diseases reviewed here, patients with CLD reported significantly lower health quality status, more bad mental and physical health days, a significant symptom disease burden, and greater activity limitations. They also reported impairment in their ability to work, increased utilization of healthcare services, and greater out of pocket medical costs. Conclusions. CLD patients have significantly impaired HRQoL and greater healthcare utilization compared to the general population and patients with other chronic diseases. The heavy burden of illness associated with CLD highlights the need for earlier diagnosis and innovative treatment approaches that may reduce the burden of illness and concomitant costs posed by this illness.

Dataset Information

The impact of osteitis on disease severity measures and quality of life outcomes in chronic rhinosinusitis.

Publications

The impact of osteitis on disease severity measures and quality of life outcomes in chronic rhinosinusitis.

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