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

  • Rhinology
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

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). Asthma-related 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 asthma-related 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.

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Acknowledgements

The authors gratefully acknowledge the contribution of the patients who participated in this study.

Author information

Authors and Affiliations

  1. Department of Otolaryngology, University of Arizona College of Medicine, Tucson, AZ, USA

    Claire Gleadhill

  2. Klinik für Hals-, Nasen-, Ohren- Krankheiten, Hals-und Gesichtschirurgie, Kantonsspital Aarau, Aarau, Switzerland

    Marlene M. Speth

  3. Department of Otolaryngology—Head and Neck Surgery, Medical Sciences Building, University of Cincinnati College of Medicine, Room 6410, 231 Albert Sabin Way, Cincinnati, OH, 45267-0528, USA

    Isabelle Gengler, Katie M. Phillips & Ahmad R. Sedaghat

  4. Edward Via College of Osteopathic Medicine—Carolinas, Spartanburg, USA

    Lloyd P. Hoehle

  5. Department of Otolaryngology, Harvard Medical School, Boston, MA, USA

    David S. Caradonna & Stacey T. Gray

  6. Division Otolaryngology, Beth Israel Deaconness Medical Center, Boston, MA, USA

    David S. Caradonna

  7. Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Boston, MA, USA

    Stacey T. Gray

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  1. Claire Gleadhill
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  2. Marlene M. Speth
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  3. Isabelle Gengler
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  8. Ahmad R. Sedaghat
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Correspondence to Ahmad R. Sedaghat.

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This study and its design was approved by the institutional human studies committee.

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Gleadhill, C., Speth, M.M., Gengler, I. et al. Chronic rhinosinusitis disease burden is associated with asthma-related emergency department usage. Eur Arch Otorhinolaryngol 278, 93–99 (2021). https://doi.org/10.1007/s00405-020-06259-2

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  • DOI: https://doi.org/10.1007/s00405-020-06259-2

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