Premium
Relationship between chronic rhinosinusitis exacerbation frequency and asthma control
Author(s) -
Banoub Raphael G.,
Phillips Katie M.,
Hoehle Lloyd P.,
Caradonna David S.,
Gray Stacey T.,
Sedaghat Ahmad R.
Publication year - 2018
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1002/lary.26901
Subject(s) - medicine , asthma , exacerbation , confidence interval , chronic rhinosinusitis , sinusitis , antibiotics , linear regression , surgery , machine learning , computer science , microbiology and biotechnology , biology
Objectives/Hypothesis To determine the association between the frequency of acute chronic rhinosinusitis (CRS) exacerbations (AECRS) and the degree of asthma control in asthmatic CRS patients. Study Design Cross‐sectional study. Methods We prospectively recruited 108 asthmatic CRS patients as participants. Asthma control was assessed using the Asthma Control Test (ACT). The frequency of AECRS was assessed using three previously described indirect metrics for AECRS: the frequency of patient‐reported sinus infections, CRS‐related antibiotics use, and CRS‐related oral corticosteroids use in the last 3 months. CRS symptom severity was measured using the 22‐item Sinonasal Outcome Test (SNOT‐22). Associations between ACT score and metrics for AECRS were performed using linear regression while controlling for clinical and demographic characteristics, including SNOT‐22 score. Results ACT score was significantly and negatively associated with the frequency of patient‐reported sinus infections (adjusted linear regression coefficient [β] = −1.2, 95% confidence interval [CI]: −2.3 to −0.1, P = .033), CRS‐related antibiotics courses (adjusted β = −1.4, 95% CI: −2.3 to −0.5, P = .004), and CRS‐related oral corticosteroid courses (adjusted β = −1.5, 95% CI: −2.5 to −0.5, P = .004) in the last 3 months, independent of characteristics including SNOT‐22 score. Poor asthma control could be detected using one or more sinus infections (70.6% sensitivity, 47.3% specificity), CRS‐related antibiotics (50.0% sensitivity, 73.0% specificity), or CRS‐related oral corticosteroids (58.8% sensitivity, 71.6% specificity) in the last 3 months. Conclusions AECRS are negatively associated with the level of asthma control in asthmatic CRS patients, independent of CRS symptom severity. These results highlight AECRS as a distinct clinical manifestation of CRS that should be routinely assessed in CRS patients. Level of Evidence 2c. Laryngoscope , 128:1033–1038, 2018