Cluster Analysis of Chronic Rhinosinusitis Suggests Gender-Based Differences

ORL J Otorhinolaryngol Relat Spec. 2019;81(1):1-9. doi: 10.1159/000492966. Epub 2018 Nov 20.

Abstract

Purpose: We aimed to evaluate the interaction between the overall severity of chronic rhinosinusitis (CRS) before treatment and subjective improvement following surgical or medical treatment.

Procedures: A group of 97 patients with CRS completed the visual analog scale (VAS) symptom score and the Sino-Nasal Outcome Test 22 (SNOT-22) questionnaire in the moment of their sinus computerized tomography (CT) scan. Data were analyzed via a 2-step cluster analysis based on gender, polyp presence, CT scan, and VAS scores for symptoms.

Results: There were 3 clusters: the first cluster comprised 37 female patients with CRS without nasal polyps (CRSsNP), the second cluster comprised 30 patients with CRS and NP (CRSwNP; 15 males and 15 females); and third cluster had 30 male patients with CRS without NP (CRSsNP). Different symptom patterns between clusters were identified. After adjustment for polyp presence, gender, eosinophilia (p = 0.021), and the SNOT-22 score (p = 0.005) were found to be better outcome predictors than the CT score (p = 0.26).

Conclusion: Long-term patient satisfaction is significantly associated with the subjective symptom severity prior to treatment, i.e., postnasal drip and overall disease severity (SNOT-22 score), but not with the objective severity of the disease (CT score and inflammation).

Keywords: Chronic rhinosinusitis; Computerized tomography; Nasal polyps; Sino-Nasal Outcome Test 22; Visual analog scale score.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Chronic Disease
  • Cluster Analysis
  • Female
  • Humans
  • Male
  • Middle Aged
  • Patient Satisfaction
  • Quality of Life
  • Rhinitis / epidemiology*
  • Rhinitis / therapy*
  • Sex Factors
  • Sinusitis / epidemiology*
  • Sinusitis / therapy*
  • Symptom Assessment
  • Treatment Outcome
  • Young Adult