Results
A total of 1072 patients, 674 males (62.9%) and 398 females (37.1%),
were included in the study. The age distribution, the largest proportion
of participants were between 18-30 years 493 (46%) followed by those
between 31-40 years 318 (29.7%), those between 41 – 50 years 198
(18.5%) and the least responses 63 (5.9%) came from participants aging
more than 50 years. 384 (35.8%) lived in an urban areas and 688
(64.2%) lived in a rural areas. As for the marital status the majority
633 (59%) were married, 413 (38.5%) were single a minority of
participants were divorced (1.4%) and widowed (1%).
All patients had history of chronic rhino sinusitis (nasal obstruction,
mucopurulent discharge, headache, fever, post nasal discharge and
anosmia) for more than 12 weeks. There was no significant association
between having CRS and gender, place of residency, marital status nor
educational level.
Nasal endosopic examinations revealed 718 patients (69.9%) had CRS with
nasal polyps (CRSwNP) while 309 patients (30.1%) had CRS without nasal
polyps (CRSsNP). CT showed opacification of at least one sinus in all of
the patients and pan sinusitis was found in all of the patients.
Culture using Kirby Bauer technique for aerobic and anaerobic showed the
most mixed bacterial infections in all of culture and sensitivities
tests collected from middle meatus in all of the patients including
Strept. Pneumoniae , Moraxeilla catarrhalis , Anaerobic streptococci ,
Pseudomonas aeraginosa , Haemophilus influenzae , Staphylococci ,
Klebsiella pneumonia , Diphtroid bacilli and Staph.pyogens.
The scores and levels of quality of life affection as well as scores of
PHQ2 tool for assessing the risk of major depression and actual risk of
depression. The average SNOT-22 score for quality of life affection was
69.14 ± 24.6. The level of quality of life affection was moderate in 265
(24.77%) and severe in 803 (75.23%) of participants with CRS. The mean
score of PHQ-2 for assessing the risk of major depression was 4.17 ±
1.74 in participants with CRS. 216 (21.03%) were normal (not at risk of
major depression) and 856 (78.97%) were at risk of major depression as
showed in table (1).
The mean number of lost days of work in the preceding three months due
to CRS was 3.30 and used to assess loss of productivity. 427 (66.5%)
were never absent from work due to CRS, 111 (17.3%) were absent for
less than 3 days due to CRS, 104 (16.2%) were absent for 3 days and
more due to CRS.
The tested whether the severely impaired quality of life in CRS patients
were associated with increased risk depression and lost productivity as
showed in table (2). A significant difference in risk of depression was
present between levels of quality of life affection (p <
0.001), where it has been observed that people with severely affected
quality of life are at higher risk of depression than those with
moderately affected quality of life (88% vs 12%). There was also an
observed significant difference in the absences from work due to CRS
within the levels of quality of life affection (p < 0.001).
Higher rates of absences were found in the group with severely affected
quality of life compared to the moderately affected quality of life
(19.7% and 19.9% vs 10.1% and 5%).
According to the Kessler Psychological Distress Scale (10 items
representing five psychological distress traits were assessed with a
five-point scale) we found 759 patients (70.8%) were positive with a
mean total perceived stress score of 16.92 ± 7.34, whereas 313(29.2%)
were negative with a mean total perceived stress score of 6.08 ± 2.7.
The difference was statistically significant (p < 0.001).