Does chronic rhinosinusitis relate to systemic hypoxemia?

Abstract

Objectives: Determine if chronic rhinosinusitis (CRS) is associated with systemic hypoxemia.

Methods: Outpatient otolaryngology visits for 12 months were analyzed, identifying patients with a diagnosis of CRS, without a comorbid diagnosis of pulmonary disease, and an oxygen saturation measurement within 14 days of the otolaryngology visit. Oxygen saturation (SpO₂) measures (average SpO₂, minimum SpO₂ and proportion abnormal SpO₂) were compared between CRS patients (with nasal polyps [NP] and without NP) and a control cohort of otology patients, also without pulmonary disease with univariate and multivariate analysis.

Results: Among 640 unique CRS patients with 3105 encounters, the mean and minimum SpO₂ measurements were 97.6% (97.5%-97.7%) and 97.3% (97.2%-97.5%), respectively. Among 3613 control patients with 25 073 encounters, the mean and minimum SpO₂ measurements were 97.3% (97.3%-97.4%) and 97.1% (97.1%-97.2%), respectively. When comparing mean and minimum SpO₂ among CRSsNP (97.5% and 97.2%), CRScNP (97.3% and 97.0%) and control patients (97.3% and 97.1%), no statistically significant differences were found among the 3 groups in mean and minimum SpO₂ adjusting for age and sex (P = .183 and P = .464, respectively, ANOVA). With respect to the presence of an abnormally low oxygen saturation (SpO₂ ≤ 94%), 4.4% of the CRSsNP, 10.9% of the CRScNP and 7.3% of the control patients demonstrated a low oxygen saturation (P = .013).

Conclusion: CRS alone does not objectively contribute to systemic hypoxemia, although a subset of CRScNP patients may have abnormally low SpO₂, possibly warranting SpO₂ assessment in this group of patients.

Level of evidence: 3.

Keywords: asthma; chronic rhinosinusitis; dyspnea; hypoxemia; hypoxia; unified airway.