Sinonasal Quality of Life in Children With Cystic Fibrosis
Sinonasal Quality of Life in Children With Cystic Fibrosis
复制标题
DOI：
10.1001/jamaoto.2016.0979
复制
发表时间：
2016-08-01
影响因子：
7.8
通讯作者：
Parikh, Sanjay R.
中科院分区：
文献类型：
--
作者：
Chan, Dylan K.;McNamara, Sharon;Parikh, Sanjay R.
重要意义鼻窦炎是囊性纤维化儿童最常见的耳鼻喉科主诉。目的评估慢性鼻窦炎(CRS)在慢性鼻窦炎(CRS)儿童队列中的发病率和对生活质量的影响。设计、设置和参与者对在一家学术儿科医院的三级CF诊所进行常规季度评估的连续儿童CF患者进行的调查研究。调查是在2012年12月至2013年1月期间完成的。MAIN结果和测量旨在评估CRS诊断的主要标准和经过验证的儿童鼻窦生活质量量表Sinonasal-5(SN-5)。结果在102名符合条件的患者中，47名(46%)2-20岁的儿童(平均12.9[5.6]岁；24名女性[51%])完成了调查。根据使用的确切诊断标准，5(11%)至18(38%)的CF儿童有CRS。SN-5的平均领域(2.16；95%CI，2.02~2.30)和总体视觉模拟评分(8.26；95%CI，8.01~8.51)对生活质量的影响最小，与治疗后的历史评分相当。影响最大的是鼻塞(3.07；95%CI，2.80~3.34)和鼻窦炎(2.68；；95%CI，2.42~2.94)，而过敏(1.83；95%CI，1.65~2.01)、情绪障碍(1.76；95%CI，1.56~1.96)、活动受限(1.43；95%CI，1.31~1.57)影响最小。确诊为CRS的儿童SN-5平均得分较高(2.60；95%CI，2.31~2.89 vs 2.05；95%CI，1.90~2.20；差值0.55；95%CI，0.29~0.80)。25名患者(53%)曾接受过鼻窦炎的治疗。SN-5评分与CRS治疗史无相关性。结论在本研究中，有症状的CRS发生率较高，但对生活质量的影响相对较低。使用标准化评估量表，包括共识诊断标准和有效的生活质量调查，可能有助于指导转诊和管理决策。
IMPORTANCE Sinusitis is the most common otolaryngologic complaint in children with cystic fibrosis (CF). However, basic knowledge about the effect of sinusitis on these children is lacking.OBJECTIVE To evaluate the incidence and quality-of-life impact of chronic rhinosinusitis (CRS) in an unbiased cohort of children with CF.DESIGN, SETTING, AND PARTICIPANTS Survey study of consecutive pediatric patients with CF presenting for routine quarterly evaluation at a tertiary CF clinic at an academic pediatric hospital. Surveys were completed during the period from December 2012 to January 2013.MAIN OUTCOMES AND MEASURES Surveys designed to assess major criteria for diagnosis of CRS and a validated pediatric sinonasal quality-of-life instrument, the Sinonasal-5 (SN-5). Statistical analysis was performed to evaluate association between demographic features and survey responses.RESULTS Of the 102 consecutive eligible patients, 47 children (46%) aged 2 to 20 years (mean [SD] age, 12.9 [5.6] years; 24 [51%] female) completed the surveys. Depending on the exact diagnostic criteria used, 5 (11%) to 18 (38%) of children with CF had CRS. Mean domain (2.16; 95% CI, 2.02-2.30) and overall visual-analog scale (8.26; 95% CI, 8.01-8.51) scores on the SN-5 were consistent with minimal effect on quality of life and comparable to historical posttreatment scores. Mean scores on nasal obstruction (3.07; 95% CI, 2.80-3.34) and sinusitis (2.68;; 95% CI, 2.42-2.94) were the most affected domains, whereas allergy (1.83; 95% CI, 1.65-2.01), emotional disturbance (1.76; 95% CI, 1.56-1.96), and activity restriction (1.43; 95% CI, 1.31-1.57) were minimally affected. Children with a diagnosis of CRS had higher mean SN-5 scores (2.60; 95% CI, 2.31-2.89 vs 2.05; 95% CI, 1.90-2.20; difference of 0.55; 95% CI, 0.29-0.80). Twenty-five patients (53%) had undergone some treatment for sinusitis. There was no association between SN-5 score and CRS treatment history.CONCLUSIONS AND RELEVANCE In this study, the incidence of symptomatic CRS was high, but quality-of-life impact was relatively low among children with CF. Use of standardized assessment scales, including consensus diagnostic criteria and validated quality-of-life surveys, may be helpful to guide referral and management decisions.