Adherence to guidelines prior to endoscopic sinus surgery in patients with chronic rhinosinusitis and asthma.

IF 1 4区医学 Q3 MEDICINE, GENERAL & INTERNAL Danish medical journal Pub Date : 2024-01-25 DOI:10.61409/A04230241

Lotte Buskbjerg Nøhr, Therese Ovesen, Kasra Zainali-Gill

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Abstract

Introduction: Optimal care for patients with simultaneous chronic rhinosinusitis (CRS) and asthma is often complicated due to interaction between these conditions. This study depicts the lack of attention to asthma within the otorhinolaryngological field, and the relationship between CRS and asthma, including the risk of revision surgery in such patients.

Methods: A retrospective cohort study was conducted on patients undergoing functional endoscopic sinus surgery (FESS) because of CRS with nasal polyps (CRSwNP) and without nasal polyps in a five-year period. Patients were examined for adherence to guidelines, asthma, revision FESS, allergies and septo-/turbinoplasty. Results were compared to international reports.

Results: A total of 589 patients had FESS because of CRS of whom 203 (34.5%) had co-existing asthma. A higher risk of asthma (relative risk (RR) = 1.82 (95% confidence interval (CI): 1.29-2.56), p less-than 0.001) and revision FESS (RR = 2.20 (95% CI: 1.33-3.65), p less-than 0.001) was found in patients with CRSwNP. Attention to asthma was poor in patients with no asthma diagnosis before referral.

Conclusions: Asthma was lower in the study population than in the literature. Danish national guidelines on CRS management are insufficient regarding attention to asthma. Results call attention to the need for more multidisciplinary team management.

Funding: None.

Trial registration: Not relevant.

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慢性鼻窦炎和哮喘患者在接受内窥镜鼻窦手术前遵守指南的情况。

导言：同时患有慢性鼻炎（CRS）和哮喘的患者，由于这两种疾病之间的相互作用，其最佳治疗往往比较复杂。本研究描述了耳鼻喉科领域对哮喘缺乏关注，以及 CRS 与哮喘之间的关系，包括此类患者接受翻修手术的风险：对五年内因鼻息肉（CRSwNP）和无鼻息肉而接受功能性内窥镜鼻窦手术（FESS）的患者进行了回顾性队列研究。研究人员对患者是否遵守指南、哮喘、鼻内窥镜鼻窦手术翻修、过敏和鼻中隔/鼻窦成形术进行了检查。结果与国际报告进行了比较：结果：共有 589 名患者因 CRS 而进行了 FESS 手术，其中 203 人（34.5%）同时患有哮喘。发现 CRSwNP 患者发生哮喘（相对风险 (RR) = 1.82（95% 置信区间 (CI)：1.29-2.56），P 小于 0.001）和翻修 FESS（RR = 2.20（95% CI：1.33-3.65），P 小于 0.001）的风险较高。转诊前未确诊哮喘的患者对哮喘的关注度较低：研究人群中的哮喘发病率低于文献报道。丹麦国家 CRS 管理指南在关注哮喘方面存在不足。研究结果提醒人们需要更多的多学科团队管理：无：试验登记：不相关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Danish medical journal MEDICINE, GENERAL & INTERNAL-

CiteScore

2.30

自引率

6.20%

发文量

审稿时长

3-8 weeks

期刊介绍： The Danish Medical Journal (DMJ) is a general medical journal. The journal publish original research in English – conducted in or in relation to the Danish health-care system. When writing for the Danish Medical Journal please remember target audience which is the general reader. This means that the research area should be relevant to many readers and the paper should be presented in a way that most readers will understand the content. DMJ will publish the following articles: • Original articles • Protocol articles from large randomized clinical trials • Systematic reviews and meta-analyses • PhD theses from Danish faculties of health sciences • DMSc theses from Danish faculties of health sciences.