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Acta Otolaryngol. 2018 Feb;138(2):153-158. doi: 10.1080/00016489.2017.1380313. Epub 2017 Oct 9.

Utilization patterns of systemic corticosteroid use for chronic rhinosinusitis.

Author information

1
a Department of Otolaryngology , Harvard Medical School , Boston , MA , USA.
2
b Department of Otolaryngology , Massachusetts Eye and Ear Infirmary , Boston , MA , USA.
3
c Division of Otolaryngology , Beth Israel Deaconess Medical Center , Boston , MA , USA.
4
d Department of Otolaryngology and Communication Enhancement , Boston Children's Hospital , Boston , MA , USA.

Abstract

OBJECTIVE:

We sought to characterize the utilization pattern and factors associated with use of systemic corticosteroids for CRS.

METHODS:

This was a cross-sectional study of 236 participants with CRS who were prospectively recruited. Participants reported the number of CRS-related oral corticosteroid courses taken in the last year. Baseline CRS symptomatology was measured using the 22-item Sinonasal Outcome Test (SNOT-22) and SNOT-22 sleep, nasal, otologic/facial pain and emotional subdomain scores. Clinical and demographic characteristics were also collected. Association was determined between patient characteristics and oral corticosteroid use in the last year for CRS.

RESULTS:

Sleep (p = .026), nasal (p < .001) and otologic/facial pain (p = .022) SNOT-22 subdomain scores, and nasal polyps (p = .007) were associated with CRS-related oral corticosteroid use. In study participants without polyps, past CRS-related oral corticosteroid use was associated with sleep (adjusted OR = 1.56, 95%CI: 1.01-2.40, p = .043), otologic/facial pain (adjusted OR = 1.65, 95%CI: 1.09-2.51, p = .019) and nasal subdomain scores (adjusted OR = 1.59, 95%CI: 1.01-2.51, p = .047). In study participants with polyps, past CRS-related oral corticosteroid use was only associated with the nasal subdomain score (adjusted OR = 2.20, 95%CI: 1.40-3.45, p = .001).

CONCLUSIONS:

Past CRS-related oral corticosteroid use was associated with increased baseline severity of specific symptoms, which were different depending on the presence of polyps.

KEYWORDS:

Chronic rhinosinusitis; SNOT-22; emotional symptoms; facial pain; nasal symptoms; oral corticosteroids; otologic symptoms; polyps; principal component analysis; sleep

PMID:
28990841
DOI:
10.1080/00016489.2017.1380313
[Indexed for MEDLINE]

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