title: Association between Chronic Rhinosinusitis and Health-Related Quality of Life in Adults with Cystic Fibrosis.
abstract: BACKGROUND
  Over the past four decades, the median age of survival has nearly doubled for individuals living with cystic fibrosis (CF). Chronic diseases such as chronic rhinosinusitis increase in prevalence with age. In the non-CF population, chronic rhinosinusitis is associated with reduced health-related quality of life.
  
  
  OBJECTIVE
  Our objectives were to determine the prevalence of chronic rhinosinusitis among adults with CF and to evaluate the impact of chronic rhinosinusitis on health-related quality of life.
  
  
  METHODS
  Individuals from a large academic teaching hospital in Vancouver, British Columbia, Canada, were eligible to participate in this cross-sectional study. Included subjects were at least 19 years of age, had a confirmed diagnosis of CF, and attended the CF clinic between September 2013 and April 2014. Participants completed a CF-specific health-related quality of life questionnaire (the Cystic Fibrosis Questionnaire-Revised for adolescents and adults over 14 years of age [CFQ-R 14+]) and underwent symptom and endoscopic assessment for diagnosis of chronic rhinosinusitis. Medical charts were reviewed for potential confounders, including sociodemographic (age, sex, and body mass index) and clinical (age at CF diagnosis, type of CF mutation, lung function, and chronic Pseudomonas aeruginosa infection) factors. Multivariable linear regression was used to model the relationship between chronic rhinosinusitis and CFQ-R 14+ domains, adjusted for potential confounders.
  
  
  RESULTS
  A total of 121 individuals were contacted in the clinic, of whom 113 (93.4%) consented to participate. The prevalence of chronic rhinosinusitis was found to be 59.2% (95% confidence interval [CI], 49.6-68.2%). Sociodemographic and clinical factors were similarly distributed between chronic rhinosinusitis-positive and chronic rhinosinusitis-negative groups. Lung function, as measured by FEV1 (% predicted value), did not significantly differ between participants with versus those without chronic rhinosinusitis (mean difference, 2.0%; 95% CI, -8.1% to 13.0%). Following adjustment for sex and lung function, individuals with chronic rhinosinusitis reported significantly worse scores on the respiratory symptoms domains compared with their counterparts without chronic rhinosinusitis (regression coefficient, -3.93; 95% CI, -8.02 to 0.15).
  
  
  CONCLUSIONS
  The majority of adults with CF have evidence of concomitant chronic rhinosinusitis. Chronic rhinosinusitis is independently associated with worse respiratory symptom on the CFQ-R 14+. Chronic rhinosinusitis should be diagnosed and managed to optimize the health-related quality of life of adults with CF. Clinical trial registered with clinicaltrials.gov (NCT02003079).
authors.affiliation: 1 School of Population and Public Health.|2 Division of Otolaryngology, St. Paul's Sinus Centre, and.
authors.forename: Al-Rahim R
authors.initials: AR
authors.lastname: Habib
authors.affiliation: 1 School of Population and Public Health.
authors.forename: Jane A
authors.identifier: http://orcid.org/0000-0003-2295-393X
authors.initials: JA
authors.lastname: Buxton
authors.affiliation: 1 School of Population and Public Health.
authors.forename: Joel
authors.initials: J
authors.lastname: Singer
authors.affiliation: 3 Division of Respirology, Department of Medicine, St. Paul's Hospital, University of British Columbia, Vancouver, British Columbia, Canada.
authors.forename: Pearce G
authors.initials: PG
authors.lastname: Wilcox
authors.affiliation: 2 Division of Otolaryngology, St. Paul's Sinus Centre, and.
authors.forename: Amin R
authors.initials: AR
authors.lastname: Javer
authors.affiliation: 3 Division of Respirology, Department of Medicine, St. Paul's Hospital, University of British Columbia, Vancouver, British Columbia, Canada.
authors.forename: Bradley S
authors.initials: BS
authors.lastname: Quon
mesh_terms: D000328:Adult; D001955:British Columbia; D002908:Chronic Disease; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D003550:Cystic Fibrosis / Q000150:complications*; D005260:Female; D006304:Health Status; D006784:Hospitals, Teaching; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011788:Quality of Life; D012220:Rhinitis / Q000453:epidemiology*; D012720:Severity of Illness Index; D012852:Sinusitis / Q000453:epidemiology*; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: cystic fibrosis; quality of life; sinusitis