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Rhinology/Allergy

Positive Correlation Between Lund-Mackay Scores With Asthma Severity

Monday, October 2, 2023
8:18 AM - 8:24 AM East Coast USA Time
Location: 103BC
Disclosure(s):
Anyull D. Bohorquez Caballero, MD: No relevant relationships to disclose.
Estephania Candelo, MD, MSc: No relevant relationships to disclose.
Introduction: Chronic rhinosinusitis (CRS) and asthma are prevalent inflammatory diseases postulated to be interlinked based on the unified airway theory. Data on the impact of treating the upper airway on the lower airways is limited. Previous studies have looked at the effect of CRS treatment on asthma outcomes, with controversial conclusions. Moreover, the current evidence correlating both diseases is scant. We aim to determine the correlation of asthma severity with Lund MacKay-CT (LMK) scores in CRS patients.

Methods: This retrospective study included 160 patients diagnosed with CRS and Asthma seen at Mayo Clinic between 2013 and 2022. CRS severity was evaluated using the LMK score, and patients were classified according to the Global Initiative for Asthma (GINA) 2022 as having mild (1), moderate (2), or severe asthma (3). The LMK was calculated using pre-operative CT imaging, and asthma severity was assessed using medical records up to three months before endoscopic sinus surgery. A one-way analysis of variance (ANOVA) test was used to calculate the correlation between LMK scores and asthma severity.

Results: Of the 160 patients, 118 (73.7%) had CRS with nasal polyps, and 36 (22.5%) had CRS without nasal polyps. Similarly, 45 (28.1%), 94 (58.7%), and 21(13.1%) had mild, moderate, and severe asthma, respectively. Mild asthma patients had a mean LMK score of 10.2 (SD 6.21), moderate asthma had a mean LMS score of 13.6(SD 5.9), and severe asthma had a mean LMK score of 15.1 (SD 5.34). There is a significant difference in LMK scores between asthma severity groups (F= 6.48, p=0.002). Aspirin-exacerbated respiratory disease (AERD) influences, but does not eliminate, the statistical significance of the relationship between LMK score and asthma severity (F= 4.38, p=0.015). In addition, a positive correlation between LMK and the number of asthma medications was observed (r= 0.21, p=0.027).

Conclusions: This study is the first to evaluate the correlation between asthma severity and imaging findings in CRS patients. The relationship between LMK scores and mild and severe asthma were significantly correlated in our analysis.