The effect of diabetes mellitus on chronic rhinosinusitis and sinus surgery outcome

Zi Zhang, Nithin D. Adappa, Ebbing Lautenbach, Alexander G Chiu, Laurel Doghramji, Timothy J. Howland, Noam A. Cohen, James N. Palmer

Research output: Contribution to journalArticle

27 Citations (Scopus)

Abstract

Background: Patients with diabetes mellitus (DM) are known to be prone to infection. However, the association between diabetes and chronic rhinosinusitis (CRS) has not been well studied. We sought to determine the effects of DM on CRS culture results and quality of life (QOL) after functional endoscopic sinus surgery (FESS). Methods: We conducted a retrospective cohort study. Adult CRS patients undergoing FESS were recruited from October 1, 2007 to December 31, 2011. Patient demographics, comorbidities, medication use, and Lund-Mackay CT scores were collected prior to FESS. Intraoperative culture was obtained. Preoperative and 1-month, 3-month, and 6-month postoperative QOL was measured by scores on the 22-item Sinonasal Outcome Test (SNOT-22). A mixed effects model was performed for analysis. Results: Among the 376 CRS patients included, 19 patients (5.05%) had DM. Compared to non-DM patients, DM patients were significantly more likely to have Pseudomonas aeruginosa (26.32% vs 7.56%; p = 0.004) and Gram-negative rods (26.32% vs 8.96%; p = 0.013), but there was no significant difference in the prevalence of Staphylococcus aureus; DM patients were also significantly more likely to have nasal polyps and gastroesophageal reflux disease. Additionally, DM patients had significantly less improvement of postoperative SNOT-22 scores from baseline to 6-month follow-up than non-DM patients (adjusted mean = 11.14, 95% CI (0.14, 22.15), p = 0.047) after adjusting for all the other risk factors for CRS. Conclusion: DM patients may be prone to Gram-negative bacterial sinus infections, and have significantly worse short-term postoperative QOL. Special postoperative care may need to be considered in CRS patients with DM.

Original languageEnglish (US)
Pages (from-to)315-320
Number of pages6
JournalInternational Forum of Allergy and Rhinology
Volume4
Issue number4
DOIs
StatePublished - 2014

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Diabetes Mellitus
Quality of Life
Gram-Negative Bacterial Infections
Nasal Polyps
Postoperative Care
Gastroesophageal Reflux
Pseudomonas aeruginosa
Staphylococcus aureus
Comorbidity
Cohort Studies
Retrospective Studies
Demography
Infection

Keywords

  • Chronic rhinosinusitis
  • Diabetes mellitus
  • Infection
  • Pseudomonas aeruginosa
  • Quality of life

ASJC Scopus subject areas

  • Immunology and Allergy
  • Otorhinolaryngology

Cite this

Zhang, Z., Adappa, N. D., Lautenbach, E., Chiu, A. G., Doghramji, L., Howland, T. J., ... Palmer, J. N. (2014). The effect of diabetes mellitus on chronic rhinosinusitis and sinus surgery outcome. International Forum of Allergy and Rhinology, 4(4), 315-320. https://doi.org/10.1002/alr.21269

The effect of diabetes mellitus on chronic rhinosinusitis and sinus surgery outcome. / Zhang, Zi; Adappa, Nithin D.; Lautenbach, Ebbing; Chiu, Alexander G; Doghramji, Laurel; Howland, Timothy J.; Cohen, Noam A.; Palmer, James N.

In: International Forum of Allergy and Rhinology, Vol. 4, No. 4, 2014, p. 315-320.

Research output: Contribution to journalArticle

Zhang, Z, Adappa, ND, Lautenbach, E, Chiu, AG, Doghramji, L, Howland, TJ, Cohen, NA & Palmer, JN 2014, 'The effect of diabetes mellitus on chronic rhinosinusitis and sinus surgery outcome', International Forum of Allergy and Rhinology, vol. 4, no. 4, pp. 315-320. https://doi.org/10.1002/alr.21269
Zhang, Zi ; Adappa, Nithin D. ; Lautenbach, Ebbing ; Chiu, Alexander G ; Doghramji, Laurel ; Howland, Timothy J. ; Cohen, Noam A. ; Palmer, James N. / The effect of diabetes mellitus on chronic rhinosinusitis and sinus surgery outcome. In: International Forum of Allergy and Rhinology. 2014 ; Vol. 4, No. 4. pp. 315-320.
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abstract = "Background: Patients with diabetes mellitus (DM) are known to be prone to infection. However, the association between diabetes and chronic rhinosinusitis (CRS) has not been well studied. We sought to determine the effects of DM on CRS culture results and quality of life (QOL) after functional endoscopic sinus surgery (FESS). Methods: We conducted a retrospective cohort study. Adult CRS patients undergoing FESS were recruited from October 1, 2007 to December 31, 2011. Patient demographics, comorbidities, medication use, and Lund-Mackay CT scores were collected prior to FESS. Intraoperative culture was obtained. Preoperative and 1-month, 3-month, and 6-month postoperative QOL was measured by scores on the 22-item Sinonasal Outcome Test (SNOT-22). A mixed effects model was performed for analysis. Results: Among the 376 CRS patients included, 19 patients (5.05{\%}) had DM. Compared to non-DM patients, DM patients were significantly more likely to have Pseudomonas aeruginosa (26.32{\%} vs 7.56{\%}; p = 0.004) and Gram-negative rods (26.32{\%} vs 8.96{\%}; p = 0.013), but there was no significant difference in the prevalence of Staphylococcus aureus; DM patients were also significantly more likely to have nasal polyps and gastroesophageal reflux disease. Additionally, DM patients had significantly less improvement of postoperative SNOT-22 scores from baseline to 6-month follow-up than non-DM patients (adjusted mean = 11.14, 95{\%} CI (0.14, 22.15), p = 0.047) after adjusting for all the other risk factors for CRS. Conclusion: DM patients may be prone to Gram-negative bacterial sinus infections, and have significantly worse short-term postoperative QOL. Special postoperative care may need to be considered in CRS patients with DM.",
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AU - Adappa, Nithin D.

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AU - Doghramji, Laurel

AU - Howland, Timothy J.

AU - Cohen, Noam A.

AU - Palmer, James N.

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N2 - Background: Patients with diabetes mellitus (DM) are known to be prone to infection. However, the association between diabetes and chronic rhinosinusitis (CRS) has not been well studied. We sought to determine the effects of DM on CRS culture results and quality of life (QOL) after functional endoscopic sinus surgery (FESS). Methods: We conducted a retrospective cohort study. Adult CRS patients undergoing FESS were recruited from October 1, 2007 to December 31, 2011. Patient demographics, comorbidities, medication use, and Lund-Mackay CT scores were collected prior to FESS. Intraoperative culture was obtained. Preoperative and 1-month, 3-month, and 6-month postoperative QOL was measured by scores on the 22-item Sinonasal Outcome Test (SNOT-22). A mixed effects model was performed for analysis. Results: Among the 376 CRS patients included, 19 patients (5.05%) had DM. Compared to non-DM patients, DM patients were significantly more likely to have Pseudomonas aeruginosa (26.32% vs 7.56%; p = 0.004) and Gram-negative rods (26.32% vs 8.96%; p = 0.013), but there was no significant difference in the prevalence of Staphylococcus aureus; DM patients were also significantly more likely to have nasal polyps and gastroesophageal reflux disease. Additionally, DM patients had significantly less improvement of postoperative SNOT-22 scores from baseline to 6-month follow-up than non-DM patients (adjusted mean = 11.14, 95% CI (0.14, 22.15), p = 0.047) after adjusting for all the other risk factors for CRS. Conclusion: DM patients may be prone to Gram-negative bacterial sinus infections, and have significantly worse short-term postoperative QOL. Special postoperative care may need to be considered in CRS patients with DM.

AB - Background: Patients with diabetes mellitus (DM) are known to be prone to infection. However, the association between diabetes and chronic rhinosinusitis (CRS) has not been well studied. We sought to determine the effects of DM on CRS culture results and quality of life (QOL) after functional endoscopic sinus surgery (FESS). Methods: We conducted a retrospective cohort study. Adult CRS patients undergoing FESS were recruited from October 1, 2007 to December 31, 2011. Patient demographics, comorbidities, medication use, and Lund-Mackay CT scores were collected prior to FESS. Intraoperative culture was obtained. Preoperative and 1-month, 3-month, and 6-month postoperative QOL was measured by scores on the 22-item Sinonasal Outcome Test (SNOT-22). A mixed effects model was performed for analysis. Results: Among the 376 CRS patients included, 19 patients (5.05%) had DM. Compared to non-DM patients, DM patients were significantly more likely to have Pseudomonas aeruginosa (26.32% vs 7.56%; p = 0.004) and Gram-negative rods (26.32% vs 8.96%; p = 0.013), but there was no significant difference in the prevalence of Staphylococcus aureus; DM patients were also significantly more likely to have nasal polyps and gastroesophageal reflux disease. Additionally, DM patients had significantly less improvement of postoperative SNOT-22 scores from baseline to 6-month follow-up than non-DM patients (adjusted mean = 11.14, 95% CI (0.14, 22.15), p = 0.047) after adjusting for all the other risk factors for CRS. Conclusion: DM patients may be prone to Gram-negative bacterial sinus infections, and have significantly worse short-term postoperative QOL. Special postoperative care may need to be considered in CRS patients with DM.

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