Risk of new‐onset and prevalent disease in chronic rhinosinusitis: A prospective cohort study
Annemarie G. Hirsch, Brian S. Schwartz, Cara Nordberg, Bruce K. Tan, Robert P. Schleimer, Robert C. Kern, Anju T. Peters, Karen Bandeen‐Roche, Ashton E. Lehmann
Abstract
Abstract Background Chronic rhinosinusitis (CRS) is accompanied by burdensome comorbid conditions. Understanding the relative timing of the onset of these conditions could inform disease prevention, detection, and management. Objective To evaluate the association between CRS and new‐onset and prevalent asthma, noncystic fibrosis bronchiectasis (NCFBE), chronic obstructive pulmonary disease (COPD), gastroesophageal reflux disease (GERD), and obstructive sleep apnea (OSA). Methods We conducted a prospective cohort study among primary care patients using a detailed medical and symptom questionnaire in 2014 and again in 2020. We used questionnaire and electronic health record (EHR) data to determine CRS status: CRS SE (moderate to severe symptoms with EHR evidence), CRS E (limited symptoms with EHR evidence), CRS S (moderate to severe symptoms without EHR evidence), CRS neg (limited symptoms and no EHR evidence; reference). We evaluated the association between CRS status and new‐onset and prevalent disease using logistic regression to estimate odds ratios (ORs) and 95% confidence intervals (CIs). Results There were 7847 and 4445 respondents to the 2014 and 2020 questionnaires, respectively. CRS SE (vs CRS neg ) was associated with increased odds of new‐onset asthma (OR, 1.74 [CI, 1.09–2.77), NCFBE (OR, 1.87 [CI, 1.12–3.13]), COPD (OR, 1.73 [CI, 1.14–2.68]), GERD (OR, 1.95 [CI, 1.61–2.35]), and OSA (OR, 1.91 [CI, 1.39–2.62]). Similarly, increased odds were observed for associations with the prevalence of these conditions. Conclusion The findings from the study support further exploration of CRS as a target for the prevention and detection of asthma, NCFBE, COPD, GERD, and OSA.