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The negative impact of chronic rhinosinusitis on the health-related quality of life among adult patients with cystic fibrosis

  • Daniel J. Lee
    Affiliations
    Department of Otolaryngology-Head and Neck Surgery, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada

    Department of Otolaryngology-Head & Neck Surgery, University of Toronto, Toronto, Ontario, Canada

    Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
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  • Jenna Sykes
    Affiliations
    Adult Cystic Fibrosis Centre, St Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada
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  • Katherine Griffin
    Affiliations
    Adult Cystic Fibrosis Centre, St Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada
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  • Christopher W. Noel
    Affiliations
    Department of Otolaryngology-Head and Neck Surgery, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada

    Department of Otolaryngology-Head & Neck Surgery, University of Toronto, Toronto, Ontario, Canada

    Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
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  • Brian Hyung
    Affiliations
    Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
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  • Kamalprit Chokar
    Affiliations
    Adult Cystic Fibrosis Centre, St Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada
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  • Christopher MKL Yao
    Affiliations
    Department of Otolaryngology-Head and Neck Surgery, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada

    Department of Otolaryngology-Head & Neck Surgery, University of Toronto, Toronto, Ontario, Canada

    Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
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  • Elizabeth Tullis
    Affiliations
    Department of Otolaryngology-Head & Neck Surgery, University of Toronto, Toronto, Ontario, Canada

    Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada

    Division of Respirology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
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  • John M. Lee
    Correspondence
    Corresponding author.
    Affiliations
    Department of Otolaryngology-Head and Neck Surgery, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada

    Department of Otolaryngology-Head & Neck Surgery, University of Toronto, Toronto, Ontario, Canada

    Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
    Search for articles by this author

      Abstract

      Background

      With improved survival in cystic fibrosis (CF) patients, it is crucial to evaluate the impact of chronic co-morbidities such as chronic rhinosinusitis (CRS). The objectives were 1) To determine the prevalence of CRS with a large series of CF patients 2) To evaluate the impact of CRS on the Health-Related Quality of Life (HRQoL) of CF patients and 3) To compare CRS-specific, CF-specific and general HRQoL instruments.

      Methods

      Consecutive CF patients from the Toronto Adult Cystic Fibrosis Centre were recruited between March 2018 and January 2020. Participants completed the 22-Item Nasal Outcome Test (SNOT-22), Cystic Fibrosis Questionnaire-Revised for adolescents and adults over 14 years of age (CFQ-R), Cystic Fibrosis Quality of Life Evaluative Self-administered Test (CF-QUEST) and the 36-Item Short Form Survey (SF-36). HRQoL scores were correlated using Spearman's correlation coefficients.

      Results

      Out of 195 patients eligible for analysis, the prevalence of CRS with positive endoscopic findings was 42.6% (95% confidence interval: 35.5–49.8%). CRS patients reported significantly lower HRQoL with higher SNOT-22 scores and lower scores in the respiratory domain of CFQ-R and physical health domains of CF-QUEST and SF-36. The physical (ρ= −0.63) and mental (ρ= −0.66) domains of SF-36 and CF-QUEST (ρ= −0.76) had a strong correlation with SNOT-22. Higher scores of SNOT-22 nasal subdomains correlated with lower scores of SF-36, CFQ-R and CF-QUEST.

      Conclusion

      CRS is a prevalent co-morbidity of CF patients, which significantly reduces HRQoL. SNOT-22, CFQ-R, CF-QUEST and SF-36 were strongly correlated. Severity of sinonasal symptoms have a strong correlation with HRQoL in CF patients.

      Keywords

      Abbreviations:

      CF (Cystic Fibrosis), CRS (Chronic Rhinosinusitis), HRQOL (Health-Related Quality of Life), SNOT-22 (the 22-Item Nasal Outcome Test), CFQ-R (Cystic Fibrosis Questionnaire-Revised for adolescents and adults over 14 years of age), CF-QUEST (Cystic Fibrosis Quality of Life Evaluative Self-administered Test), SF-36 (the 36-Item Short Form Survey)
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