Association between Chronic Rhinosinusitis and Health-Related Quality of Life in Adults with Cystic Fibrosis
Association between Chronic Rhinosinusitis and Health-Related Quality of Life in Adults with Cystic Fibrosis
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DOI：
10.1513/annalsats.201504-191oc
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发表时间：
2015-08-01
影响因子：
8.3
通讯作者：
Quon, Bradley S.
中科院分区：
文献类型：
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作者：
Habib, Al-Rahim R.;Buxton, Jane A.;Quon, Bradley S.
理由：在过去的四十年中，囊性纤维化（CF）患者的中位生存年龄几乎翻了一番。慢性鼻窦炎等慢性疾病的患病率随着年龄的增长而增加。在非CF人群中，慢性鼻窦炎与健康相关的生活质量降低。Objectives：我们的目的是确定慢性鼻窦炎的患病率与CF成人和评估慢性鼻窦炎对健康相关的生活质量的影响。方法：个人从一个大型学术教学医院在温哥华，不列颠哥伦比亚省，加拿大，有资格参加这项横断面研究。纳入的受试者年龄至少为19岁，确诊为CF，并在2013年9月至2014年4月期间到CF诊所就诊。参与者完成了CF特定的健康相关生活质量问卷（囊性纤维化量表-修订版，适用于14岁以上的青少年和成人[CFQ-R 14+]），并接受了症状和内窥镜评估，以诊断慢性鼻窦炎。审查病历中的潜在混杂因素，包括社会人口统计学（年龄、性别和体重指数）和临床（CF诊断时的年龄、CF突变类型、肺功能和慢性铜绿假单胞菌感染）因素。多变量线性回归模型慢性鼻窦炎和CFQ-R 14+域之间的关系，调整为潜在的confounders. Measures和主要结果：共121个人在诊所接触，其中113（93.4%）同意参加。慢性鼻窦炎的患病率为59.2%（95%置信区间[CI]，49.6-68.2%）。慢性鼻窦炎阳性组和慢性鼻窦炎阴性组的社会人口学和临床因素分布相似。以FEV 1（%预测值）测量的肺功能在慢性鼻窦炎患者与非慢性鼻窦炎患者之间无显著差异（平均差异为2.0%; 95%CI为-8.1%至13.0%）。调整性别和肺功能后，慢性鼻窦炎患者的呼吸道症状评分显著低于无慢性鼻窦炎患者（回归系数为-3.93，95%CI为-8.02至0.15）。慢性鼻窦炎与CFQ-R 14+上的呼吸道症状恶化独立相关。慢性鼻窦炎应被诊断和管理，以优化与CF成人的健康相关的生活质量。
Rationale: Over the past four decades, the median age of survival has nearly doubled for individuals living with cystic fibrosis (CF). Chronic diseases such as chronic rhinosinusitis increase in prevalence with age. In the non-CF population, chronic rhinosinusitis is associated with reduced health-related quality of life.Objectives: Our objectives were to determine the prevalence of chronic rhinosinusitis among adults with CF and to evaluate the impact of chronic rhinosinusitis on health-related quality of life.Methods: Individuals from a large academic teaching hospital in Vancouver, British Columbia, Canada, were eligible to participate in this cross-sectional study. Included subjects were at least 19 years of age, had a confirmed diagnosis of CF, and attended the CF clinic between September 2013 and April 2014. Participants completed a CF-specific health-related quality of life questionnaire (the Cystic Fibrosis Questionnaire-Revised for adolescents and adults over 14 years of age [CFQ-R 14+]) and underwent symptom and endoscopic assessment for diagnosis of chronic rhinosinusitis. Medical charts were reviewed for potential confounders, including sociodemographic (age, sex, and body mass index) and clinical (age at CF diagnosis, type of CF mutation, lung function, and chronic Pseudomonas aeruginosa infection) factors. Multivariable linear regression was used to model the relationship between chronic rhinosinusitis and CFQ-R 14+ domains, adjusted for potential confounders.Measurements and Main Results: A total of 121 individuals were contacted in the clinic, of whom 113 (93.4%) consented to participate. The prevalence of chronic rhinosinusitis was found to be 59.2% (95% confidence interval [CI], 49.6-68.2%). Sociodemographic and clinical factors were similarly distributed between chronic rhinosinusitis-positive and chronic rhinosinusitisnegative groups. Lung function, as measured by FEV1 (% predicted value), did not significantly differ between participants with versus those without chronic rhinosinusitis (mean difference, 2.0%; 95% CI, -8.1% to 13.0%). Following adjustment for sex and lung function, individuals with chronic rhinosinusitis reported significantly worse scores on the respiratory symptoms domains compared with their counterparts without chronic rhinosinusitis (regression coefficient, -3.93; 95% CI, -8.02 to 0.15).Conclusions: The majority of adults with CF have evidence of concomitant chronic rhinosinusitis. Chronic rhinosinusitis is independently associated with worse respiratory symptom on the CFQ-R 14+. Chronic rhinosinusitis should be diagnosed and managed to optimize the health-related quality of life of adults with CF.