Chronic rhinosinusitis disease burden is associated with asthma-related emergency department usage

Abstract

Purpose Chronic rhinosinusitis (CRS) disease burden is associated with pulmonary status in asthmatic CRS patients. Asthma-related emergency department (ED) usage is a predictor of asthma-related mortality. We sought to determine whether measures of CRS disease burden are associated with asthma-related ED usage. Methods We prospectively recruited 263 asthmatic CRS patients for this cross-sectional study. CRS burden was measured using the 22-item Sinonasal Outcome Test (SNOT-22), and patient-reported CRS-related antibiotic usage and CRS-related oral corticosteroids usage over the preceding year. Asthma-related ED visits over the prior year were also assessed. Results Of all participants, 18.6% had at least 1 asthma-related ED visit (mean 0.3 ED visits for the whole cohort). Asthmarelated ED usage was associated with SNOT-22 score [adjusted rate ratio (RR) = 1.02, 95% CI 1.01-1.03, p = 0.040] and CRS-related oral corticosteroids usage in the past year (RR = 1.52, 95% CI 1.26-1.83, p < 0.001). From the SNOT-22 score, asthma-related ED usage was only associated with the nasal subdomain score (RR = 1.08, 95% CI 1.03-1.13, p = 0.001). These measures of CRS disease burden could be used with good sensitivity and specificity to detect patients with asthmarelated ED usage in the past year, the majority of whom were undertreated for their asthma. Conclusions Measures of CRS disease burden are associated with and can be used to detect, patients having asthma-related ED usage. These results further solidify the connection between CRS and asthma disease courses, and also present an opportunity to use CRS disease burden as a tool for identifying-and implementing greater treatment of-patients at highest risk for asthma-related mortality.

Is overreliance on short-acting β2-agonists associated with health risks in the older asthma population?

“…This may limit the findings’ generalisability, especially to a younger population. Health administrative data did not allow us to assess individual-level clinical risk factors that are associated with mortality risk, like severity of asthma with pulmonary functions, eosinophil counts and/or other biomarkers [ 29 ], asthma control [ 30 , 31 ] and systemic inflammation [ 32 ]. However, we used proxy measures of baseline asthma severity including baseline severe asthma exacerbations and baseline use of asthma medications to adjust for asthma severity in our model.…”

The Saudi Initiative for Asthma - 2021 Update

“…Treatment with intranasal corticosteroids has been associated with a decrease in asthma hospitalization and ED. [ 193 248 249 ]…”

Manifesto on united airways diseases (UAD): an Interasma (global asthma association – GAA) document

“…The presence of CRS adversely affects the course of asthma leading to more severe disease with more frequent and severe exacerbations as well as worse HRQoL and other comorbidities (96)(97)(98)(99).…”

“…The more severe the CRS is in patients with asthma, the greater the risk is for the loss of asthma control as reflected by the greater frequency of emergency department visits (99).…”