中重度慢性鼻窦炎伴鼻息肉病的症状负担和健康相关生活质量

S. Chen, M. Biswas, M. Scott, M. Small, L. Lee, S. Ruiz, Dr. Emmanuel Osemeke Bienonwu
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摘要

背景:慢性鼻窦炎伴鼻息肉病(CRSwNP)影响高达4%的个体。常见症状包括鼻塞/阻塞、鼻腔分泌物、面部疼痛和嗅觉下降。本研究描述了在现实世界的临床环境中,患者和医生报告的CRSwNP症状负担和健康相关的生活质量(HRQOL)。方法:这项跨国、地理多样的时间点调查邀请医生对连续5名确诊双侧中重度CRSwNP的成年人进行评估(连续抽样),再加上接下来的2名复发性鼻息肉患者和≥1例息肉切除手术(过抽样)。在整个连续样本中,按照医生确定的CRSwNP严重程度类别和哮喘合并症类别(总样本)评估患者和医生的调查。在匹配的样本中比较患者和医生的反应。结果:1782名患者的总样本包括1296名(72.7%)来自连续采样和486名(27.3%)来自过采样。在连续样本(平均年龄46.9岁)中,1122人(86.6%)患有中度CRSwNP,174人(13.4%)患有严重CRSwNP。在1697名已知哮喘状态的患者中,708名(41.7%)患有哮喘,989名(58.3%)没有。患者自我报告的症状频率、严重程度和HRQOL负担随着CRSwNP严重程度和合并哮喘的增加而恶化。与患者相比,医生少报了患病率、严重程度以及症状对日常活动的影响(匹配样本)。结论:来自现实世界的患者和医生都描述了CRSwNP的相当大的负担,但医生始终报告的症状比患者更少、更轻。这表明,在评估CRSwNP症状负担和HRQOL时,需要更以患者为中心的观点。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Symptom burden and health-related quality of life in moderate to severe chronic rhinosinusitis with nasal polyposis
Background: Chronic rhinosinusitis with nasal polyposis (CRSwNP) affects up to 4% of individuals. Common symptoms include nasal congestion/obstruction, nasal discharge, facial pain, and reduced sense of smell. This study describes patient- and physician-reported CRSwNP symptom burden and health-related quality of life (HRQOL) in a real-world clinical setting. Methods: This multinational, geographically diverse, point-in-time survey invited physicians to evaluate 5 consecutive adults with confirmed bilateral moderate to severe CRSwNP (consecutive sampling) plus the next 2 patients with recurrent nasal polyps and ≥1 surgery for polyp removal (oversampling). Patients’ and physicians’ surveys were assessed in the entire consecutive sample and by categories of physician-determined CRSwNP severity, and by categories of asthma comorbidity (total sample). Patients’ and physicians’ responses were compared in a matched sample. Results: The total sample of 1,782 patients comprised 1,296 (72.7%) from consecutive sampling and 486 (27.3%) from oversampling. Among the consecutive sample (mean age, 46.9 years), 1,122 (86.6%) had moderate and 174 (13.4%) had severe CRSwNP. Of 1,697 patients from total sampling with known asthma status, 708 (41.7%) had asthma and 989 (58.3%) did not. Patients’ self-reported symptom frequency, severity, and burden on HRQOL worsened with increasing CRSwNP severity and comorbid asthma. Physicians underreported prevalence, severity, and impact of symptoms on daily activities compared with patients (matched sample). Conclusion: Patients and physicians from real-world settings both described a considerable burden of CRSwNP, but physicians consistently reported fewer and less severe symptoms than patients. This suggests a more patient-centric view is needed when assessing CRSwNP symptom burden and HRQOL.
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