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F.A. Houssein - A.R. Sedaghat - K.M. Phillips

DOI: 10.4193/Rhin24.378

BACKGROUND A patient-centered and directly measurable definition for acute exacerbation of chronic rhinosinusitis (AECRS) has been developed as “a flare up of symptoms beyond day-to-day variation, lasting at least 3 days, and to which a distinct negative impact on a patient’s quality of life (QOL) or functionality can be attributed”. Our aim is to understand how this definition correlates with previously used metrics. METHODOLOGY: Cross-sectional study of chronic rhinosinusitis (CRS) patients. The number of AECRS (using this novel definition), courses of CRS-related systemic antibiotics and corticosteroids taken for these AECRS, and number of asthma exacerbations in the past 6 months was queried. Disease-specific quality of life was measured using the 22-item Sinonasal Outcome Test. RESULTS: A total of 237 CRS patients were enrolled. In the 6-month period prior to study enrollment, the mean number of AECRS was 4.2 while the mean number of systemic antibiotics or corticosteroids taken for these AECRS was 1.6 reflecting patients received rescue medication for 33% of AECRS. The number of AECRS was weakly correlated with number of systemic rescue medications and SNOT-22 score. For asthmatic CRS patients, numbers of AECRS and asthma exacerbations were correlated. Finally, comorbidities were associated with higher AECRS frequency by 29% in migraine and 41% in active tobacco users. CONCLUSIONS: We achieved our aim by showing the AECRS definition correlates with systemic rescue medication usage, disease-specific QOL and asthma exacerbations. Our results demonstrate that indirect measures of AECRS may not capture all AECRS. Furthermore, comorbid migraine and tobacco use are associated with AECRS frequency.

Rhinology 0-0: 0-0, 0000