Cluster analysis of chronic rhinosinusitis suggests gender-based differences

Jurlin, Lana and Gregurić, Tomislav and Baudoin, Tomislav and Grgić, Marko Velimir and Pažanin, Leo and Košec, Andro and Scadding, Glenis and Kalogjera, Livije (2018) Cluster analysis of chronic rhinosinusitis suggests gender-based differences. ORL, 81 (1). pp. 1-9. ISSN 0301-1569

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Abstract

Purpose: We aimed to evaluate the interaction between the overall severity of chronic rhinosinusitis (CRS) before treatment and subjective improvement following surgical or medical treatment. ----- Procedures: A group of 97 patients with CRS completed the visual analog scale (VAS) symptom score and the Sino-Nasal Outcome Test 22 (SNOT-22) questionnaire in the moment of their sinus computerized tomography (CT) scan. Data were analyzed via a 2-step cluster analysis based on gender, polyp presence, CT scan, and VAS scores for symptoms. ----- Results: There were 3 clusters: the first cluster comprised 37 female patients with CRS without nasal polyps (CRSsNP), the second cluster comprised 30 patients with CRS and NP (CRSwNP; 15 males and 15 females); and third cluster had 30 male patients with CRS without NP (CRSsNP). Different symptom patterns between clusters were identified. After adjustment for polyp presence, gender, eosinophilia (p = 0.021), and the SNOT-22 score (p = 0.005) were found to be better outcome predictors than the CT score (p = 0.26). ----- Conclusion: Long-term patient satisfaction is significantly associated with the subjective symptom severity prior to treatment, i.e., postnasal drip and overall disease severity (SNOT-22 score), but not with the objective severity of the disease (CT score and inflammation).

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