Determinants for the course of acute sinusitis in adult general practice patients.
BACKGROUND
Although the prognosis of acute sinusitis is important, little is known about it and the factors predicting its course in a general practice population.


OBJECTIVE
To determine the course of acute sinusitis and factors predicting it in adults in general practice.


METHODS
The prognostic value of demographic and clinical factors and the patient's emotional state, for example anxious or depressed, were determined prospectively by means of multivariate analysis.


METHODS
Resolution of facial pain, resumption of daily activities, and the patient's reported improvement. Factors with a significant predictive value were used to classify the patients into three different groups: quick, moderate, and slow recovery.


RESULTS
The median time from enrollment to recovery was six (range percentile 25-75: 4-10) days in a population of 177 patients. Factors predictive of a prolonged clinical course were: female sex (hazard ratio (HR) 0.60; 95% confidence interval (CI) 0.42 to 0.83), history longer than 14 days before inclusion (HR 0.62; 95% CI 0.41 to 0.94), headache, cold, or cough as a reason for the encounter (HR 0.65; 95% CI 0.44 to 0.96), and absence of cervical adenopathy (HR 0.71; 95% CI 0.51 to 0.96). Antibiotic treatment did not influence the course of disease. The median time to recovery was three days for patients with a quick, five days for those with a moderate, and seven days for those with a slow recovery.


CONCLUSIONS
In general practice acute sinusitis is mostly a self limiting disease. A limited number of characteristics are predictive of a (slightly) prolonged clinical course of acute sinusitis in general practice.
Stalman
W A
WA
Julius Center for General Practice and Patient Oriented Research, University Medical Center Utrecht, P O Box 85060, 3508 AB Utrecht, The Netherlands. wstalman@knmg.nl
van Essen
G A
GA
van der Graaf
Y
Y
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D005157:Facial Pain / Q000209:etiology / Q000628:therapy; D005194:Family Practice; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011379:Prognosis; D012852:Sinusitis / Q000628:therapy*; D013997:Time Factors