The Lund-Mackay staging system for chronic rhinosinusitis: how is it used and what does it predict?
OBJECTIVE
The Lund-Mackay score is widely used in assessment of chronic rhinosinusitis. We aimed to describe its relationship to other measures of pre- and post-treatment health status.


METHODS
Multicenter prospective study of 1840 patients undergoing surgery for chronic rhinosinusitis in the UK.


RESULTS
There was no absolute threshold for surgery, but patients with higher Lund-Mackay scores underwent more extensive surgery. There was no correlation between Lund-Mackay and SNOT-22 scores. The Lund-Mackay increased with increasing grade of polyposis. The Lund-Mackay score was associated with symptom reduction (coefficient = 0.24, P = 0.02) complication rates (odds ratio, 1.08, 95%CI 1.06 to 1.1), and revision rates (odds ratio, 1.03, 95% CI 1.001 to 1.06).


CONCLUSIONS
The Lund-Mackay score measures a different aspect of disease to "subjective" symptom scores. However, it correlates well with other markers of disease severity, the nature of surgery offered, and its outcome.


CONCLUSIONS
This demonstrates the strengths and limitations of a commonly used staging system.
Hopkins
Claire
C
Clinical Effectiveness Unit, Royal College of Surgeons of England, London. clairehopkins@yahoo.com
Browne
John P
JP
Slack
Rob
R
Lund
Valerie
V
Brown
Peter
P
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects; D001241:Aspirin / Q000009:adverse effects; D001249:Asthma / Q000150:complications; D002908:Chronic Disease; D004342:Drug Hypersensitivity / Q000150:complications; D005260:Female; D005500:Follow-Up Studies; D005544:Forecasting; D006304:Health Status; D006801:Humans; D006967:Hypersensitivity / Q000150:complications; D008297:Male; D008875:Middle Aged; D015508:Nasal Obstruction / Q000145:classification; D009298:Nasal Polyps / Q000145:classification; D011183:Postoperative Complications; D011446:Prospective Studies; D011788:Quality of Life; D012086:Reoperation; D012220:Rhinitis / Q000145:classification* / Q000601:surgery; D012720:Severity of Illness Index; D012852:Sinusitis / Q000145:classification* / Q000601:surgery; D012907:Smoking; D014057:Tomography, X-Ray Computed
D000894:Anti-Inflammatory Agents, Non-Steroidal; D001241:Aspirin