IMPACT OF CHRONIC RHINOSINUSITIS WITH NASAL POLYPOSIS ON QUALITY OF LIFE BY SINO-NASAL SURGERY HISTORY

Abstract

Introduction Chronic rhinosinusitis with nasal polyposis (CRSwNP) is associated with high symptom burden and poor health-related quality of life (HRQoL). The objective of this study was to assess the impact of CRSwNP on HRQoL among patients with disease refractory to maximal medical treatment, defined by history of sino-nasal surgery. Methods Patients with CRSwNP from 9 European centers in the Global Allergy and Asthma European Network completed a cross-sectional survey measuring HRQoL by the 36-Item Short Form questionnaire (SF-36). SF-36 mean physical component summary (PCS) and mental component summary (MCS) scores were compared with age-adjusted population norms and between groups of patients with and without a history of sino-nasal surgery. Results Patients with CRSwNP (n = 338) with or without a history of sino-nasal surgery had significantly lower mean PCS (−6.3 and −3.5, respectively) and MCS (−4.1 and −2.6, respectively) scores compared with population norms (P ≤ 0.005 for all). Differences in PCS and MCS scores in these patients vs population norms are consistent with differences considered clinically meaningful (≥2 and ≥3, respectively). Patients with sino-nasal surgery history (n = 155), compared with those without history of surgery (n = 183), had similar mean MCS score but significantly lower mean PCS score (−2.8; P = 0.017). Conclusions Patients with CRSwNP have worse physical and mental health than population norms. Patients with CRSwNP with sino-nasal surgery history experience similar mental health but significantly worse physical health than those without surgery history, indicating a greater unmet need in this subgroup.