Cargando…

3030 Symptom profile of chronic rhinosinusitis versus obstructive sleep apnea in a tertiary rhinology clinic

OBJECTIVES/SPECIFIC AIMS: Patients with undiagnosed obstructive sleep apnea (OSA) will often present to an otolaryngologist with symptoms of chronic rhinosinusitis (CRS). Differentiating CRS from OSA may help obviate unnecessary and costly work-up for CRS. This study analyzes symptom profiles of suc...

Descripción completa

Detalles Bibliográficos
Autores principales: Yong Ji, Keven Seung, Risoli, Thomas J., Kuchibhatla, Maragatha, Chan, Lyndon, Hachem, Ralph Abi, Jang, David
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cambridge University Press 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6799466/
http://dx.doi.org/10.1017/cts.2019.289
_version_ 1783460291726540800
author Yong Ji, Keven Seung
Risoli, Thomas J.
Kuchibhatla, Maragatha
Chan, Lyndon
Hachem, Ralph Abi
Jang, David
author_facet Yong Ji, Keven Seung
Risoli, Thomas J.
Kuchibhatla, Maragatha
Chan, Lyndon
Hachem, Ralph Abi
Jang, David
author_sort Yong Ji, Keven Seung
collection PubMed
description OBJECTIVES/SPECIFIC AIMS: Patients with undiagnosed obstructive sleep apnea (OSA) will often present to an otolaryngologist with symptoms of chronic rhinosinusitis (CRS). Differentiating CRS from OSA may help obviate unnecessary and costly work-up for CRS. This study analyzes symptom profiles of such patients to help identify which require polysomnography. METHODS/STUDY POPULATION: This is a three-year retrospective analysis of adult patients seen in an academic practice with a rhinologic chief complaint. The 22-Item Sinonasal Outcomes Test (SNOT-22) survey, which is a validated patient-reported outcome measure widely adopted for CRS featuring a symptom scale of 1 (least severe) to 5 (most severe), was completed by patients with untreated OSA confirmed on polysomnography without CRS (OSA group) and a control group of CRS patients (CRS group). Results were compared using Chi-square test (categorical) and Wilcoxon rank-sum test (continuous) with Bonferroni correction, and multiple logistic regression. RESULTS/ANTICIPATED RESULTS: 43 patients were included in the OSA group [mean apnea-hypopnea index: 27.9 (SD: 21.2)] and 124 patients were included in the CRS group. The CRS group demonstrated significantly higher scores in nasal (p < 0.001), extra-nasal (p < 0.001) and ear/facial symptom domains (p = 0.001) while the OSA group reported higher psychological (p = 0.028) and sleep symptom domain scores (p = 0.052). As for the cardinal symptoms of CRS, nasal discharge and loss of smell were significantly higher in the CRS group (both p < 0.001), whereas facial pain (p = 0.117) and nasal obstruction (p = 0.198) were not significantly different between the two groups. After adjustment, for every 1-point increase in a patient’s score for ear pain, thick nasal discharge and loss of smell or taste, their odds of having CRS increased by a factor of 3.18 [(95% CI 1.61-6.29), p = 0.001], 1.60 [(95% CI 1.22-2.10], p = 0.001] and 1.36 [(95% CI 1.04-1.78), p = 0.025], respectively, compared to having OSA. OSA patients were more likely to choose a sleep-related symptom as a “most important complaint” (MIC) (p < 0.001). Facial pain and nasal obstruction were the most common MIC in the rhinologic domain for OSA patients, whereas thick nasal discharge and post-nasal discharge were the most common MIC for CRS patients. DISCUSSION/SIGNIFICANCE OF IMPACT: For patients presenting with rhinologic symptoms, the SNOT-22 can help identify those with undiagnosed OSA. OSA should be suspected in patients with sleep and psychological dysfunction as their primary complaints without the significant nasal drainage and anosmia that characterizes CRS.
format Online
Article
Text
id pubmed-6799466
institution National Center for Biotechnology Information
language English
publishDate 2019
publisher Cambridge University Press
record_format MEDLINE/PubMed
spelling pubmed-67994662019-10-28 3030 Symptom profile of chronic rhinosinusitis versus obstructive sleep apnea in a tertiary rhinology clinic Yong Ji, Keven Seung Risoli, Thomas J. Kuchibhatla, Maragatha Chan, Lyndon Hachem, Ralph Abi Jang, David J Clin Transl Sci Science and Health Policy/Ethics/Health Impacts/Outcomes Research OBJECTIVES/SPECIFIC AIMS: Patients with undiagnosed obstructive sleep apnea (OSA) will often present to an otolaryngologist with symptoms of chronic rhinosinusitis (CRS). Differentiating CRS from OSA may help obviate unnecessary and costly work-up for CRS. This study analyzes symptom profiles of such patients to help identify which require polysomnography. METHODS/STUDY POPULATION: This is a three-year retrospective analysis of adult patients seen in an academic practice with a rhinologic chief complaint. The 22-Item Sinonasal Outcomes Test (SNOT-22) survey, which is a validated patient-reported outcome measure widely adopted for CRS featuring a symptom scale of 1 (least severe) to 5 (most severe), was completed by patients with untreated OSA confirmed on polysomnography without CRS (OSA group) and a control group of CRS patients (CRS group). Results were compared using Chi-square test (categorical) and Wilcoxon rank-sum test (continuous) with Bonferroni correction, and multiple logistic regression. RESULTS/ANTICIPATED RESULTS: 43 patients were included in the OSA group [mean apnea-hypopnea index: 27.9 (SD: 21.2)] and 124 patients were included in the CRS group. The CRS group demonstrated significantly higher scores in nasal (p < 0.001), extra-nasal (p < 0.001) and ear/facial symptom domains (p = 0.001) while the OSA group reported higher psychological (p = 0.028) and sleep symptom domain scores (p = 0.052). As for the cardinal symptoms of CRS, nasal discharge and loss of smell were significantly higher in the CRS group (both p < 0.001), whereas facial pain (p = 0.117) and nasal obstruction (p = 0.198) were not significantly different between the two groups. After adjustment, for every 1-point increase in a patient’s score for ear pain, thick nasal discharge and loss of smell or taste, their odds of having CRS increased by a factor of 3.18 [(95% CI 1.61-6.29), p = 0.001], 1.60 [(95% CI 1.22-2.10], p = 0.001] and 1.36 [(95% CI 1.04-1.78), p = 0.025], respectively, compared to having OSA. OSA patients were more likely to choose a sleep-related symptom as a “most important complaint” (MIC) (p < 0.001). Facial pain and nasal obstruction were the most common MIC in the rhinologic domain for OSA patients, whereas thick nasal discharge and post-nasal discharge were the most common MIC for CRS patients. DISCUSSION/SIGNIFICANCE OF IMPACT: For patients presenting with rhinologic symptoms, the SNOT-22 can help identify those with undiagnosed OSA. OSA should be suspected in patients with sleep and psychological dysfunction as their primary complaints without the significant nasal drainage and anosmia that characterizes CRS. Cambridge University Press 2019-03-27 /pmc/articles/PMC6799466/ http://dx.doi.org/10.1017/cts.2019.289 Text en © The Association for Clinical and Translational Science 2019 http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an Open Access article, distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives licence (http://creativecommons.org/licenses/by-ncnd/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is unaltered and is properly cited. The written permission of Cambridge University Press must be obtained for commercial re-use or in order to create a derivative work.
spellingShingle Science and Health Policy/Ethics/Health Impacts/Outcomes Research
Yong Ji, Keven Seung
Risoli, Thomas J.
Kuchibhatla, Maragatha
Chan, Lyndon
Hachem, Ralph Abi
Jang, David
3030 Symptom profile of chronic rhinosinusitis versus obstructive sleep apnea in a tertiary rhinology clinic
title 3030 Symptom profile of chronic rhinosinusitis versus obstructive sleep apnea in a tertiary rhinology clinic
title_full 3030 Symptom profile of chronic rhinosinusitis versus obstructive sleep apnea in a tertiary rhinology clinic
title_fullStr 3030 Symptom profile of chronic rhinosinusitis versus obstructive sleep apnea in a tertiary rhinology clinic
title_full_unstemmed 3030 Symptom profile of chronic rhinosinusitis versus obstructive sleep apnea in a tertiary rhinology clinic
title_short 3030 Symptom profile of chronic rhinosinusitis versus obstructive sleep apnea in a tertiary rhinology clinic
title_sort 3030 symptom profile of chronic rhinosinusitis versus obstructive sleep apnea in a tertiary rhinology clinic
topic Science and Health Policy/Ethics/Health Impacts/Outcomes Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6799466/
http://dx.doi.org/10.1017/cts.2019.289
work_keys_str_mv AT yongjikevenseung 3030symptomprofileofchronicrhinosinusitisversusobstructivesleepapneainatertiaryrhinologyclinic
AT risolithomasj 3030symptomprofileofchronicrhinosinusitisversusobstructivesleepapneainatertiaryrhinologyclinic
AT kuchibhatlamaragatha 3030symptomprofileofchronicrhinosinusitisversusobstructivesleepapneainatertiaryrhinologyclinic
AT chanlyndon 3030symptomprofileofchronicrhinosinusitisversusobstructivesleepapneainatertiaryrhinologyclinic
AT hachemralphabi 3030symptomprofileofchronicrhinosinusitisversusobstructivesleepapneainatertiaryrhinologyclinic
AT jangdavid 3030symptomprofileofchronicrhinosinusitisversusobstructivesleepapneainatertiaryrhinologyclinic