TRIO038 - The Advanced Endoscopic Scoring System: A Novel Grading System for Clinically Meaningful Stratification of Disease Burden in Chronic Rhinosinusitis
Friday, April 29, 2022
4:00 PM – 4:05 PM CT
Location: Landmark B
Torin Phillips Thielhelm BS; Roy R. Casiano MD; Corrina Levine MD MPH
Educational Objective: At the conclusion of this presentation, the participants should be able to 1) explain the clinical utility of the advanced endoscopic scoring; and 2) demonstrate the advanced endoscopic scoring system's quality in patient stratification over previously described endoscopic scoring systems of chronic rhinosinusitis.
Objectives: Compare the correlation of Lund Kennedy (LK) and advanced endoscopic scoring system (AES) to preoperative radiologic disease severity and Sino-Nasal Outcome Test-22 (SNOT 22). Compare the correlation of LK, radiologic disease severity, and AES with short term postoperative change in SNOT-22.
Study Design: A retrospective review of prospectively collected data in the electronic medical record.
Methods: The AES is a unique endoscopic sinus scoring system which stratifies patients by primary or revision surgery and provides detailed assessment of disease severity strata. Adult patients diagnosed with chronic rhinosinusitis with and without polyps undergoing primary or revision surgery were included in this study. Spearman correlations were utilized for direct correlation with 95% confidence interval (CI) and regression analysis adjusted for demographics and covariates for correlations greater than 0.35.
Results: 311 subjects were included. The AES demonstrated a strong correlation of 0.7 (95% CI 0.5, 0.8) in primary surgery and a correlation of 0.8 (95% CI 0.7, 0.9) in revision surgery as compared to the LK correlation of 0.4 (95% CI 0.3, 0.5). The relationship persisted when adjusted for demographics. The AES demonstrated no correlation with preoperative SNOT-22 score. However, in the subset of subjects with postoperative data (n = 54), the AES moderately correlated with postoperative SNOT-22 scores 0.5 (95% CI 0.1, 0.9).
Conclusions: The AES strongly correlates with radiologic disease severity as compared to the LK. Additionally, while there is no correlation with preoperative SNOT-22, the AES may correlate with the postoperative SNOT-22, demonstrating its potential utility in guiding patient expectations on postoperative disease course.