Utjecaj bronhijalne astme na simptome i kvalitetu života u pacijenata s kroničnim rinosinuitisom

master's thesis

• Title (english): Impact of bronchial asthma on symptoms and quality of life in patients with chronic rhinosinusitis
• Author: Matej Paić
• Mentor: Livije Kalogjera (mentor)
• Committee member: Tomislav Baudoin (predsjednik povjerenstva)
• Committee member: Mirko Ivkić (član povjerenstva)
• Committee member: Livije Kalogjera (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Othorhinolaryngology and Head and Neck Surgery); Zagreb
• Defense date and country: 2016-07-15, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Otorhinolaryngology

Abstract

Kronični rinosinuitis je upalni proces koji zahvaća sluznicu nosa i paranazalnih sinusa i česta je kronična bolest s negativnim utjecajem na kvalitetu života oboljelih. Prema EPOS-ovim smjernicama (eng. European position paper on rhinosinusitis and nasal polyps) dijagnoza se postavlja ako simptomi poput nosne opstrukcije, nosne sekrecije, postnazalnog slijeva, boli/pritiska u licu te smetnji njuha traju duže od 12 tjedana. Dva su klinički različita oblika kroničnog rinosinuitisa, s prisutnim nosnim polipima i bez prisutne polipoze. ----- Kako se pokazalo da oboljeli od kroničnog rinosinuitisa često imaju astmu kao komorbiditet, postavili smo pitanje u kojoj mjeri ona utječe na simptome i kvalitetu života oboljelih. U istraživanju je sudjelovalo 256 ispitanika diferenciranih u dvije skupine, s astmom (65 ispitanika) i bez astme (185 ispitanika). Za svakog od 65 ispitanika s astmom tražili smo para iz skupine bez astme ujednačenog po spolu, dobi, prisutnosti polipa i alergijskom statusu što je rezultiralo s ukupno 60 parova starosti između 23 i 78 godina. Svi su bili kandidati za kiruruško liječenje te su prije CT snimanja ispunili SNOT-22 upitnik kao i ocjenu simptima na vizualno analognoj skali. ----- Rezultati su pokazali da nema statistički značajne razlike između parova u ocjeni CT nalaza prema Lund Mackayu (p<0,185) kao niti većih razlika u ocjeni pojedičanih simptoma u SNOT-22 upitniku i ocjena na vizualno analognoj skali za pojedinačne simptome. Jedina se razlika pokazala za osjetilo njuha u oba od navedenih upitnika, gdje su oboljeli od astme navodili izraženije tegobe. Ukupan SNOT-22 rezultat nije se značajno razlikovao između skupina (p<0,357). Granična razlika postojala je za ocjenu problema s usnivanjem i jutarnjim umorom (p<0,053 odnosno p<0,069) u rezultatima SNOT-22 upitnika.

Naposljetku zaključujemo da astma kao komorbiditet nema utjecaja na simptome i kvalitetu života kod oboljelih od CRS-a.

Abstract (english)

Chronic rhinosinusitis (CRS) is an inflammatory process affecting the nose and paranasal sinuses and is one of more common chronic diseases with a negative impact on the quality of life (QOL) in people suffering from this illness. According to the EPOS criteria (European position paper on rhinosinusitis and nasal polyps) it is diagnosed by having symptoms such as nasal obstruction, nasal secretion, postnasal drip, facial pain and hyposmia for more than 12 weeks. It is manifested in two different clinical phenotypes: chronic rhinosinusitis with nasal polyps (CRSwNP) and chronic rhinosinusitis without nasal polyps (CRSsNP). As asthma shows higher prevalence in those affected with CRS it is reasonable wondering the proportions of its impact on the health-related quality of life (HRQOL) in those patients. ----- This study included 256 CRS patients, differentiated in two groups, those with asthma comorbidity and those not affected with asthma. Each of 65 asthma patients was matched with its pair not having asthma by the age, gender and polyp criteria. Before undergoing CT scanning all of the examinees filled in SNOT-22 (Sino-nasal Outcome Test-22) and VAS (visual analog scale) questionnaire which evaluated their symptoms. ----- Statistical analysis of the collected data was carried out and no significant difference was found in Lund Mackay score between asthma and non asthma group (p<0,158), as well as no difference was observed regarding the symptoms validated via SNOT-22 and VAS questionnaire, except for the olfactory function, which was more affected in patients with comorbid asthma. Marginal significance was found between groups regarding to more pronounced difficulties with falling asleep in asthma patients (p<0,053) and also with morning tiredness (p<0,069). The overall severity of symptoms and QoL of CRS patients was not heavily, if at all affected with asthma.

• Keywords: kronični rinosinuitis (CRS); astma; kvaliteta života (QoL); Sino-Nasal Outcome Test-22 (SNOT-22)
• Keywords (english): chronic rhinosinusitis (CRS); asthma; quality of life (QOL); health-related quality of life (HRQOL); Sino-Nasal Outcome Test Questionnaire (SNOT-22)
• Language: croatian
• URN:NBN: urn:nbn:hr:105:589543
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2017-06-19 11:16:47