{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T04:03:48Z","timestamp":1785297828162,"version":"3.55.0"},"reference-count":26,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2019,7,30]],"date-time":"2019-07-30T00:00:00Z","timestamp":1564444800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[2019,11]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Acute exacerbation of chronic rhinosinusitis (AECRS) is associated with significant quality\u2010of\u2010life decreases. We sought to determine characteristics associated with an exacerbation\u2010prone phenotype in chronic rhinosinusitis (CRS).<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Cross\u2010sectional.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Tertiary care rhinology clinic.<\/jats:p><\/jats:sec><jats:sec><jats:title>Subjects<\/jats:title><jats:p>Patients with CRS (N = 209).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patient\u2010reported number of sinus infections, CRS\u2010related antibiotics, and CRS\u2010related oral corticosteroids taken in the last 12\u00a0months were used as metrics for AECRS frequency. Sinonasal symptom burden was assessed with the 22\u2010item Sinonasal Outcome Test (SNOT\u201022). Ninety patients reporting 0 for all AECRS metrics were considered to have had no AECRS in the prior 12\u00a0months. A total of 119 patients reported &gt;3 on at least 1 AECRS metric and were considered as having an exacerbation\u2010prone phenotype. Characteristics associated with patients with an exacerbation\u2010prone phenotype were identified with exploratory regression analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>An exacerbation\u2010prone phenotype was positively associated with comorbid asthma (adjusted odds ratio [OR<jats:sub>adj<\/jats:sub>] = 3.68, 95% CI: 1.42\u20109.50, <jats:italic>P<\/jats:italic> =. 007) and SNOT\u201022 (OR<jats:sub>adj<\/jats:sub> = 1.06, 95% CI: 1.04\u20101.09, <jats:italic>P<\/jats:italic> &lt;. 001). Polyps were negatively associated (OR<jats:sub>adj<\/jats:sub> = 0.27, 95% CI: 0.11\u20100.68, <jats:italic>P<\/jats:italic> =. 005) with an exacerbation\u2010prone phenotype. SNOT\u201022 score \u226524 identified patients with an exacerbation\u2010prone phenotype with a sensitivity of 93.3% and a specificity of 57.8%. Having either a SNOT\u201022 score \u226524 with a nasal subdomain score \u226512 or a SNOT\u201022 score \u226524 with an ear\/facial discomfort subdomain score \u22653 provided &gt;80% sensitivity and specificity for detecting patients prone to exacerbation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In total, these results point to a CRS exacerbation\u2010prone phenotype characterized by high sinonasal disease burden with comorbid asthma but interestingly without polyps.<\/jats:p><\/jats:sec>","DOI":"10.1177\/0194599819865474","type":"journal-article","created":{"date-parts":[[2019,7,30]],"date-time":"2019-07-30T05:14:18Z","timestamp":1564463658000},"page":"890-896","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Clinical Traits Characterizing an Exacerbation\u2010Prone Phenotype in Chronic Rhinosinusitis"],"prefix":"10.1002","volume":"161","author":[{"given":"Katie M.","family":"Phillips","sequence":"first","affiliation":[{"name":"Department of Otolaryngology Harvard Medical School Boston Massachusetts USA"},{"name":"Department of Otolaryngology Massachusetts Eye and Ear Infirmary Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric","family":"Barbarite","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Harvard Medical School Boston Massachusetts USA"},{"name":"Department of Otolaryngology Massachusetts Eye and Ear Infirmary Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lloyd P.","family":"Hoehle","sequence":"additional","affiliation":[{"name":"Edward Via College of Osteopathic Medicine\u2013Carolinas Spartanburg South Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David S.","family":"Caradonna","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Harvard Medical School Boston Massachusetts USA"},{"name":"Division of Otolaryngology Beth Israel Deaconess Medical Center Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stacey T.","family":"Gray","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Harvard Medical School Boston Massachusetts USA"},{"name":"Department of Otolaryngology Massachusetts Eye and Ear Infirmary Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmad R.","family":"Sedaghat","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery College of Medicine University of Cincinnati Cincinnati Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,7,30]]},"reference":[{"issue":"2","key":"e_1_2_8_2_1","first-page":"S1","article-title":"Clinical practice guideline (update): adult sinusitis","volume":"152","author":"Rosenfeld 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