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Asthma increases long‐term revision rates of endoscopic sinus surgery in chronic rhinosinusitis with and without nasal polyposis
Author(s) -
Gill Amarbir S.,
Smith Kristine A.,
Meeks Huong,
Oakley Gretchen M.,
Curtin Karen,
LeClair Laurie,
Howe Heather,
Orlandi Richard R.,
Alt Jeremiah A.
Publication year - 2021
Publication title -
international forum of allergy and rhinology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.503
H-Index - 46
eISSN - 2042-6984
pISSN - 2042-6976
DOI - 10.1002/alr.22779
Subject(s) - medicine , asthma , nasal polyps , sinusitis , hazard ratio , cohort , natural history , chronic rhinosinusitis , surgery , population , endoscopic sinus surgery , confidence interval , environmental health
Background Chronic rhinosinusitis with asthma (CRS‐A) has a significant impact on patient morbidity and quality of life. Nevertheless, little is known about the natural history of endoscopic sinus surgery (ESS) in this cohort. The objective of this study was to evaluate revision rates of ESS in CRS‐A and identify risk factors associated with increased likelihood for revision surgery compared to those with CRS without asthma (CRS‐alone). Methods The Utah Population Database was queried for patients age >18 years with CRS who underwent at least 1 ESS between 1996 and 2018. Demographic information and history of ESS were collected and compared between CRS‐A and CRS‐alone using chi‐square tests for categorical variables and t tests for continuous variables. Risk factors for revision surgery were analyzed using Cox proportional hazard models. Results A total of 33,090 patients (7693 CRS‐A and 25,397 CRS‐alone) were included in the final analysis. Mean follow up was 9.8 years in CRS‐A and 9.1 years in CRS‐alone ( p < 0.001). The revision rate among patients with CRS‐A (21.5%) was twice that of CRS‐alone (10.8%) ( p < 0.001). Among patients with CRS, a history of allergy ( p < 0.001), asthma ( p < 0.001), and nasal polyposis ( p < 0.001) was independently associated with increased risk of revision ESS. Patients with CRS‐A and nasal polyposis were 6 times more likely to require revision surgery than those with CRS‐alone ( p < 0.010). Conclusion The rate of revision ESS in CRS‐A was twice that of CRS‐alone; patients with CRS‐A and nasal polyposis were 6 times more likely to require revision than those with CRS‐alone. ©2021 ARSAAOA, LLC.