March 2022

ENT

STRONG AND CONSISTENT ASSOCIATIONS OF PRECEDENT CHRONIC RHINOSINUSITIS WITH RISK OF NON-CYSTIC FIBROSIS BRONCHIECTASIS

Featuring: ​ Bruce K Tan, MD, Robert C Kern, MD, Atsushi Kato, PhD
​
Read the full study here.


Abstract
Background: Chronic rhinosinusitis (CRS) and bronchiectasis commonly co-occur, but most prior studies were not designed to evaluate temporality and causality.

Objectives: In a sample representing the general population in 37 counties in Pennsylvania, and thus the full spectrum of sinonasal and relevant lung diseases, we evaluated temporality and strength of associations of CRS with non-cystic fibrosis bronchiectasis.

Methods: We completed case-control analyses for each of three primary bronchiectasis case finding methods. We used electronic health records to identify CRS and bronchiectasis with diagnoses, procedure orders, and/or specific text in sinus or chest computerized tomography (CT) scans. Controls never had any indication of bronchiectasis and were frequency-matched to the three bronchiectasis groups on age, sex, and encounter year. There were 5,329 unique persons with bronchiectasis and 33,363 without in the three analyses. Important co-occurring conditions were identified with diagnoses, medication orders, and encounter types. Logistic regression was used to evaluate associations (odds ratios [OR], 95% confidence intervals) of CRS with bronchiectasis while adjusting for confounding variables.

Results: In adjusted analyses, CRS was consistently and strongly associated with all three bronchiectasis definitions. Associations (odds ratio, 95% confidence interval) were strongest for CRS based on sinus CT scan text and were generally stronger for CRS without nasal polyps (e.g., OR = 4.46 [2.09, 9.51] for diagnosis-based bronchiectasis). On average, CRS was identified over six years before bronchiectasis.

Conclusion: Precedent CRS was strongly and consistently associated with increased risk of bronchiectasis.

Clinical implication: Early treatment of sinonasal disease may offer therapeutic strategies for prevention of bronchiectasis.



This abstract was originally published in the Journal of Allergy and Clinical Immunology on March 18, 2022. ​
Bruce K Tan, MD, associate professor of Otolaryngology - Head and Neck Surgery and Allergy and Immunology in the Department of Medicine.
Robert C Kern, MD, chair of the department of Otolaryngology - Head and Neck Surgery, George A. Sisson, MD, and professor of Otolaryngology - Head and Neck Surgery and Allergy and Immunology in the Department of Medicine.
Atsushi Kato, PhD, assistant professor of Allergy and Immunology in the Department of Medicine and Otolaryngology - Head and Neck Surgery. ​

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