Associations Between Chronic Rhinosinusitis and the Development of Non–Cystic Fibrosis Bronchiectasis

IF 8.2 1区医学 Q1 ALLERGY Journal of Allergy and Clinical Immunology-In Practice Pub Date : 2024-11-01 DOI:10.1016/j.jaip.2024.07.027

So Lim Kim MD, MSCI , Brian S. Schwartz MD, MS , Thanh-Huyen Vu MD, PhD , David B. Conley MD , Leslie C. Grammer MD , Amina Guo BS , Atsushi Kato PhD , Robert C. Kern MD , Michelle H. Prickett MD , Robert P. Schleimer PhD , Stephanie Smith MD, MPH , Whitney W. Stevens MD, PhD , Lydia Suh BS , Bruce K. Tan MD , Kevin C. Welch MD , Anju T. Peters MD, MSCI

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Abstract

Background

Studies have shown an association between chronic rhinosinusitis (CRS) and non–cystic fibrosis (CF) bronchiectasis.

Objective

We aimed to determine whether CRS increases the risk of developing non-CF bronchiectasis.

Methods

A retrospective analysis was conducted utilizing electronic medical records from an academic center. Patients with CRS without bronchiectasis, with at least 1 chest computed tomography (CT) scan performed after the diagnosis of CRS, were identified between January 2006 and December 2015. Charts were reviewed until May 2022. The control group was age-, sex-, and race-matched, and included patients without CRS, asthma, or chronic obstructive pulmonary disease (COPD) who had at least 1 chest CT scan. Bronchiectasis was identified by chest CT radiology reports. The odds of developing bronchiectasis were analyzed in patients with CRS without asthma or COPD (cohort 1) and patients with CRS with asthma or COPD (cohort 2).

Results

The odds of developing bronchiectasis were significantly higher in patients with CRS (139 of 1,594; 8.7%) than in patients in the control group (443 of 7,992; 5.5%; odds ratio OR 1.63; 95% confidence interval [95% CI] 1.34–1.99). Furthermore, the odds of developing bronchiectasis were higher in cohort 1 (63 of 863; 7.3%; OR 1.34; 05% CI 1.02–1.76) and cohort 2 (76/ of 731; 10.4%; OR 1.98; 95% CI 1.53–2.55) versus the control group. After adjusting for confounding diseases, the association was attenuated in cohort 1 (OR 1.22; 95% CI 0.92–1.61) but remained significant in cohort 2 (OR 1.78; 95% CI 1.37–2.31).

Conclusions

The CRS is associated with the future development of non-CF bronchiectasis. Patients with CRS, especially those with asthma or COPD, have a higher likelihood of developing bronchiectasis than patients without CRS.

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慢性鼻炎与非囊性纤维化支气管扩张症之间的关系。

背景：研究表明，慢性鼻炎（CRS）与非囊性纤维化（CF）支气管扩张之间存在关联：我们旨在确定 CRS 是否会增加非囊性纤维化支气管扩张症的发病风险：我们利用一家学术中心的电子病历进行了回顾性分析。2006年1月至2015年12月期间，对确诊CRS后至少进行过一次胸部计算机断层扫描（CT）的无支气管扩张的CRS患者进行了鉴定。在 2022 年 5 月之前，对这些患者的病历进行了复查。对照组的年龄、性别和种族均匹配，包括未患 CRS、哮喘或慢性阻塞性肺病 (COPD) 并至少做过一次胸部 CT 的患者。支气管扩张症通过胸部 CT 放射学报告确定。对无哮喘或慢性阻塞性肺病的 CRS 患者（队列 1）和有哮喘或慢性阻塞性肺病的 CRS 患者（队列 2）发生支气管扩张的几率进行了分析：结果：与对照组患者（443/7992 [5.5%]，OR 1.63 [1.34-1.99]）相比，CRS 患者（139/1594，8.7%）发生支气管扩张的几率明显更高。此外，与对照组相比，队列 1（63/863 [7.3%]，OR 1.34 [1.02-1.76]）和队列 2（76/731 [10.4%]，OR 1.98 [1.53-2.55]）患支气管扩张的几率更高。在对混杂疾病进行调整后，队列 1 的相关性有所减弱（OR 1.22 [0.92-1.61]），但队列 2 的相关性仍然显著（OR 1.78 [1.37-2.31]）：结论：CRS 与非慢性支气管炎支气管扩张症的未来发展有关。结论：CRS 与非慢性阻塞性肺病支气管扩张症的未来发展有关。CRS 患者，尤其是哮喘或慢性阻塞性肺病患者，比无 CRS 的患者患支气管扩张症的可能性更高。

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来源期刊

Journal of Allergy and Clinical Immunology-In Practice ALLERGYIMMUNOLOGY-IMMUNOLOGY

CiteScore

11.10

自引率

9.60%

发文量

683

审稿时长

50 days

期刊介绍： JACI: In Practice is an official publication of the American Academy of Allergy, Asthma & Immunology (AAAAI). It is a companion title to The Journal of Allergy and Clinical Immunology, and it aims to provide timely clinical papers, case reports, and management recommendations to clinical allergists and other physicians dealing with allergic and immunologic diseases in their practice. The mission of JACI: In Practice is to offer valid and impactful information that supports evidence-based clinical decisions in the diagnosis and management of asthma, allergies, immunologic conditions, and related diseases. This journal publishes articles on various conditions treated by allergist-immunologists, including food allergy, respiratory disorders (such as asthma, rhinitis, nasal polyps, sinusitis, cough, ABPA, and hypersensitivity pneumonitis), drug allergy, insect sting allergy, anaphylaxis, dermatologic disorders (such as atopic dermatitis, contact dermatitis, urticaria, angioedema, and HAE), immunodeficiency, autoinflammatory syndromes, eosinophilic disorders, and mast cell disorders. The focus of the journal is on providing cutting-edge clinical information that practitioners can use in their everyday practice or to acquire new knowledge and skills for the benefit of their patients. However, mechanistic or translational studies without immediate or near future clinical relevance, as well as animal studies, are not within the scope of the journal.