Prevalence and risk factors of chronic rhinosinusitis among Chinese: A systematic review and meta-analysis

Abstract

BackgroundChronic rhinosinusitis (CRS) can be seen in people of all ages. CRS heavily affects the quality of a patient's daily life and also causes tremendous economic burdens on patients' families and society. The prevalence of CRS in different countries varies and no systematic review of the prevalence of CRS among Chinese has been published previously. The objective of this systematic review and meta-analysis is to determine the prevalence of CRS among Chinese and to explore the main risk factors of CRS among Chinese.MethodsUsing relevant keywords, data resources including PubMed, Scopus, Web of Science, Google Scholar, Embase, Cochrane Library, Chinese National Knowledge of Infrastructure (CNKI), WANGFANG, VIP, and China Biomedical Literature database (CMB) were searched to obtain literature reporting the prevalence of and risk factors of CRS among Chinese which were clearly diagnosed with CRS from inception to 30 June 2022. The random/fixed effect model was used for meta-analysis, and the I2 index was employed to assess heterogeneity among studies. All analyses were performed by using the STATA version 16.0 software. The study was registered with PROSPERO, register number. CRD42022341877.ResultA total of 12 relevant kinds of literature were qualified for the present systematic review, including 4,033 patients. The results showed that the overall prevalence of CRS among Chinese was 10% (95%CI: 0.06–0.13, I2 = 99.6%, P < 0.001). The prevalence of CRS among Chinese who lived in urban cities was 18% (95%CI: −0.07 to 0.43, I2 = 99.9%, P < 0.001), which was obviously lower than the prevalence of CRS among Chinese who lived in rural areas (27%, 95%CI: −0.14 to 0.68, I2 = 99.8%, P < 0.001). The prevalence of CRS among Chinese before 2010 was 23% (95%CI: −0.05 to 0.50, I2 = 99.8%, P < 0.001), which was remarkably higher than the prevalence of CRS among Chinese after 2010 (7%, 95%CI: 0.05–0.09, I2 = 99.0%, P < 0.001). The prevalence of CRS among Chinese who were divorced was 17% (95%CI: 0.12–0.22, I2 = 0.0%, P = 0.436), while the prevalence of CRS among Chinese who were married, widowed, and unmarried was 9% (95%CI: 0.06–0.11, I2 = 88.1%, P = 0.004), 9% (95%CI: 0.06–0.11, I2 = 0.0%, P = 0.863), and 9% (95%CI: 0.08–0.10, I2 = 0.0%, P = 0.658), respectively. The prevalence of CRS among Han and minority Chinese was 8% (95%CI: 0.07–0.10, I2 = 69.6%, P = 0.070) and 12% (95%CI: 0.10–0.15, I2 = 38.6%, P = 0.202), respectively. The prevalence of CRS among Chinese who was never exposed to moldy or damp environments was 8% (95%CI: 0.08–0.09, I2 = 0.0%, P = 0.351), the prevalence of CRS among Chinese who was occasionally exposed to moldy or damp environments was 16% (95%CI: 0.10–0.22, I2 = 78.9%, P = 0.030), and the prevalence of CRS among Chinese who was frequently or every day exposed to moldy or damp environments was up to 20% (95%CI: 0.15–0.24, I2 = 0.0%, P = 0.558).ConclusionThis meta-analysis shows that the prevalence of CRS among Chinese is at a high level. People who have some risk factors, such as occasional or frequent or everyday exposure to moldy or damp environments, have a higher prevalence of CRS. We should attach more importance to the risk factors of CRS in clinical practice and disseminate scientific information and carry out education to lower the prevalence of CRS in China.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=341877, identifier: CRD42022341877.

Correlation between coronary heart disease severity and subsequent chronic rhinosinusitis severity: A retrospective cohort study

“…Apart from molecular mechanisms contributing to CHD development, conditions such as obesity and asthma are commonly associated with CHD or CRS [24][25][26][27]. The advancement of CHD may be associated with the severity of subsequent CRS, and this is attributable to their similar pathophysiology and associated comorbidities [17,[24][25][26][27][28]. Our findings support this possible association.…”

“…Moreover, CRS involves local aggregation of immune cells such as eosinophils, natural killer cells, and neutrophils in nasal polyps [23]. Apart from molecular mechanisms contributing to CHD development, conditions such as obesity and asthma are commonly associated with CHD or CRS [24][25][26][27]. The advancement of CHD may be associated with the severity of subsequent CRS, and this is attributable to their similar pathophysiology and associated comorbidities [17,[24][25][26][27][28].…”

“…Additionally, CRS is globally prevalent and is the most common chronic disease in the United States [13]. Although death directly caused by CRS is rare, CRS adversely affects daily life, and many patients cannot fully recover from CRS, leading to a substantial economic burden [25]. Both CHD and CRS affect many individuals and can lead to substantial health problems [13,38]; hence, identifying any correlation between them is crucial.…”

Association between Chronic Kidney Disease and Chronic Rhinosinusitis: A Longitudinal Follow-Up Study Using a National Health Screening Cohort

“…A recent systematic review of the risk factors for CRS in the Chinese population revealed that individuals residing in urban areas exhibited a lower prevalence of CRS [ 37 ]. However, other reports have focused on the impact of environmental factors, including air pollution, on CRS development [ 38 ].…”

Prevalence of Chronic Rhinosinusitis in Rajavithi Hospital Workers, Bangkok, Thailand

“…These figures are lower than the prevalence rates reported in other countries, which typically range from 5.5% to 12%. 1,[7][8][9] Among the participants who qualified for symptom-based CRS, only 6 individuals underwent nasal endoscopy and were confirmed as having CRS, resulting in a prevalence of 0.58% for endoscopy-based CRS. However, if all 20 participants who qualified for symptom-based CRS had undergone nasal endoscopy and were positive, the prevalence could have been as high as 2.53%.…”