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United airways: the impact of chronic rhinosinusitis and nasal polyps in bronchiectasic patient’s quality of life

Authors

  • J. M. Guilemany,

    1. Rhinology Unit and Smell Clinic, Department of Otorhinolaryngology, Hospital Clínic i Universitari, Barcelona
    2. Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERes), Barcelona, Spain
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  • J. Angrill,

    1. Pneumology and Respiratory Allergy, Hospital Clínic, Barcelona
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  • I. Alobid,

    1. Rhinology Unit and Smell Clinic, Department of Otorhinolaryngology, Hospital Clínic i Universitari, Barcelona
    2. Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERes), Barcelona, Spain
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  • S. Centellas,

    1. Rhinology Unit and Smell Clinic, Department of Otorhinolaryngology, Hospital Clínic i Universitari, Barcelona
    2. Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERes), Barcelona, Spain
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  • E. Prades,

    1. Rhinology Unit and Smell Clinic, Department of Otorhinolaryngology, Hospital Clínic i Universitari, Barcelona
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  • J. Roca,

    1. Rhinology Unit and Smell Clinic, Department of Otorhinolaryngology, Hospital Clínic i Universitari, Barcelona
    2. Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona
    3. Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERes), Barcelona, Spain
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  • L. Pujols,

    1. Rhinology Unit and Smell Clinic, Department of Otorhinolaryngology, Hospital Clínic i Universitari, Barcelona
    2. Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERes), Barcelona, Spain
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  • M. Bernal-Sprekelsen,

    1. Rhinology Unit and Smell Clinic, Department of Otorhinolaryngology, Hospital Clínic i Universitari, Barcelona
    2. Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERes), Barcelona, Spain
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  • C. Picado,

    1. Pneumology and Respiratory Allergy, Hospital Clínic, Barcelona
    2. Department of Medicine, University of Barcelona, Barcelona
    3. Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERes), Barcelona, Spain
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    • *

      Both senior investigators participated with equal responsibilities.

  • J. Mullol

    1. Rhinology Unit and Smell Clinic, Department of Otorhinolaryngology, Hospital Clínic i Universitari, Barcelona
    2. Department of Medicine, University of Barcelona, Barcelona
    3. Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona
    4. Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERes), Barcelona, Spain
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    • *

      Both senior investigators participated with equal responsibilities.


  • Hospital Clínic – IDIBAPS is a partner center of GA2LEN (Global Allergy and Asthma European Network).

José Mara Guilemany Toste
Department of Otorhinolaryngology
Hospital Clínic i Universitari
c/Villarroel, 170
08036 Barcelona
Catalonia
Spain

Abstract

Background:  The nose and the bronchi belong, in anatomical and physiopathological terms, to the concept of united airways. Associations between upper and lower airways diseases have been demonstrated in allergic rhinitis and asthma, nasal polyposis (NP) and asthma, chronic rhinosinusitis (CRS) and chronic obstructive pulmonary disease, and more recently CRS/NP and bronchiectasis (BQ).

Objective:  To evaluate the impact of CRS on quality of life (QoL) of patients with BQ, and to correlate these findings with the pulmonary status, nasal symptoms, and general health status.

Methods:  In a prospective study, patients with BQ (n = 80) were evaluated for CRS and NP using EP3OS criteria, and severity of BQ using chest high resolution computed tomography (HRCT)-scan. Quality of life was assessed in all patients by using specific [Sinonasal Outcome Test-20 (SNOT-20), St George Respiratory Questionnaire (SGRQ)], and generic (Short Form-36; SF-36) questionnaires.

Results:  Using SNOT-20, patients with CRS had worse QoL (2.1 ± 0.1; P < 0.001) than patients without CRS (0.4 ± 0.06). Using SGRQ total score, patients with CRS had worse QoL (43.7 ± 2.2; P < 0.001) than patients without CRS (24.7 ± 2.5). Using SF-36, patients with CRS had worse QoL, both in the physical summary (64 ± 3.4; P < 0.05) and the mental summary (65.5 ± 4.7; P < 0.05), than patients without CRS (physical summary [PS]: 76.2 ± 3.3; mental summary [MS]: 78.3 ± 5.3, respectively). Sinonasal Outcome Test-20 was correlated with SGRQ total score (= 0.72; P < 0.01), and SF-36 physical summary (= −0.63; P < 0.01). St George Respiratory Questionnaire was correlated with SF-36 on physical summary (= −0.58; P < 0.05) and with forced expiratory volume in 1 s (= −0.41; P < 0.05).

Conclusion:  These results suggested that CRS, measured by both specific and generic questionnaires, has a considerable impact on the QoL of patients with BQ.

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