Chronic rhinosinusitis exacerbation frequency predicts asthma excerbation frequency but not emergency department usage

Introduction:

There exists a strong association between chronic rhinosinusitis (CRS) disease burden and pulmonary status in asthmatic CRS patients. To determine the association between acute exacerbations of CRS (AECRS) and asthma exacerbations of varying severity.

Methods:

We prospectively recruited 105 asthmatic patients presenting to our clinics with CRS for this cross-sectional study. CRS burden was measured using the 22-item Sinonasal Outcome Test (SNOT-22), and metrics of AECRS including patient-reported sinus infections and CRS-related antibiotic usage over the preceding year. Asthma exacerbation frequency was measured using frequency of asthma-related oral corticosteroids and asthma-related emergency department (ED) visits over the prior year.

Results:

At presentation, participants reported in the prior year using a mean 1.2 courses of asthma-related oral corticosteroids and mean 0.3 asthma-related ED visits. The mean SNOT-22 score was 43.6 and in the past year, participants had a mean 2.6 sinus infections and used a mean 2.2 courses of CRS-related antibiotics. The frequency of asthma-related oral corticosteroids used was associated with the frequency of patient-reported sinus infections (adjusted relative risk [RR]= 1.23, 95%CI: 1.06 – 1.43, p = 0.007), and CRS-related antibiotics usage (adjusted RR = 1.20, 95%CI: 1.02 – 1.43, p = 0.031) but not associated with SNOT-22 score (p> 0.050). The frequency of asthma-related ED visits was not associated with any metric of CRS burden.

Conclusions:

The association between CRS disease burden and asthma exacerbations is largely driven by AECRS. This association was not found to carry through with asthma-related ED usage which may reflect the multifaceted-and often socioeconomic-utilization patterns of ED usage.

Publication History

Publication Date:
23 April 2019 (online)