Comorbidities of chronic rhinosinusitis in children and adults

IF 4.6 2区医学 Q2 ALLERGY

Clinical and Translational Allergy Pub Date : 2024-04-24 DOI:10.1002/clt2.12354

Aada Murtomäki, Alma Helevä, Paulus Torkki, Jari Haukka, Anna Julkunen-Iivari, Riikka Lemmetyinen, Mika Mäkelä, Aarno Dietz, Mikko Nuutinen, Sanna Toppila-Salmi

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Abstract

Background

Chronic rhinosinusitis (CRS) is a chronic inflammatory disease of the nose and paranasal sinuses lasting ≥12 weeks. CRS may exist with (CRSwNP) or without (CRSsNP) nasal polyps. The aim was to evaluate conditions associated with CRS in a randomized hospital cohort. We hypothesized that comorbidities and surgical procedures differ between pediatric and adult patients.

Methods

This study consisted of hospital registry data of a random sample of rhinosinusitis patients (age range 0–89 years) with the diagnosis of J32 or J33, correspondingly, registered during outpatient visits from 2005 to 2019 (n = 1461). The covariates of interest were collected from electronic health records based on ICD-10 codes and keyword searches.

Results

Among pediatric patients (n = 104), the relative proportions of CRSsNP and CRSwNP were 86% and 14% respectively. The relative proportions of adult patients (n = 1357) with CRSsNP and CRSwNP were 60% and 40%, respectively. The following comorbidities significantly differed (p < 0.05) between pediatric and adult populations: allergy, chronic otitis media, and tonsillar diseases. In total, 41 % of the children and 46% of the adults underwent baseline endoscopic sinus surgery (ESS). Additional surgeries of the ear, nose and pharynx were significantly more common among children compared with adults. Risk of revision after baseline ESS was associated (p < 0.05) with allergy, asthma, eosinophilia, CRSwNP, immunodeficiency or its suspicion, non-steroidal anti-inflammatory drug exacerbated respiratory disease, and number of any diseases ≥2.

Conclusions

Our study showed that comorbidities differ between pediatric and adult rhinosinusitis patients, as allergy, asthma and allergy, chronic otitis media, mental health disorders, and tonsils disease were significantly more prevalent among pediatric patients. Children and adults were equally treated with ESS. Notably, children underwent additional surgery on adenoids and tonsils more frequently. The effectiveness of ESS in multimorbid adults should be assessed at an individual level.

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儿童和成人慢性鼻炎的并发症

背景慢性鼻窦炎（CRS）是鼻腔和副鼻窦的一种慢性炎症性疾病，病程≥12 周。CRS可能伴有鼻息肉（CRSwNP），也可能不伴有鼻息肉（CRSsNP）。我们的目的是在随机医院队列中评估与 CRS 相关的情况。我们假设儿童患者和成人患者的合并症和手术程序有所不同。方法本研究包括 2005 年至 2019 年期间门诊登记的随机样本鼻窦炎患者（年龄在 0-89 岁之间）的医院登记数据，诊断结果相应为 J32 或 J33（n = 1461）。相关协变量是根据 ICD-10 编码和关键词搜索从电子病历中收集的。结果在儿科患者（n = 104）中，CRSsNP 和 CRSwNP 的相对比例分别为 86% 和 14%。成人患者（n = 1357）中，CRSsNP 和 CRSwNP 的相对比例分别为 60% 和 40%。以下合并症在儿童和成人之间存在显著差异（p < 0.05）：过敏、慢性中耳炎和扁桃体疾病。共有 41% 的儿童和 46% 的成人接受了基线内窥镜鼻窦手术（ESS）。与成人相比，儿童接受耳鼻喉和咽部额外手术的比例明显更高。基线ESS术后复查的风险与过敏、哮喘、嗜酸性粒细胞增多症、CRSwNP、免疫缺陷或疑似免疫缺陷、非甾体类抗炎药加重的呼吸道疾病以及任何疾病的数量≥2有关（p < 0.05）。结论我们的研究表明，儿童鼻炎患者和成人鼻炎患者的合并症有所不同，因为过敏、哮喘和过敏、慢性中耳炎、精神疾病和扁桃体疾病在儿童患者中的发病率明显更高。儿童和成人接受 ESS 治疗的情况相同。值得注意的是，儿童接受腺样体和扁桃体额外手术的频率更高。ESS对多病成人的疗效应根据个体情况进行评估。

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来源期刊

Clinical and Translational Allergy Immunology and Microbiology-Immunology

CiteScore

7.50

自引率

4.50%

发文量

117

审稿时长

12 weeks

期刊介绍： Clinical and Translational Allergy, one of several journals in the portfolio of the European Academy of Allergy and Clinical Immunology, provides a platform for the dissemination of allergy research and reviews, as well as EAACI position papers, task force reports and guidelines, amongst an international scientific audience. Clinical and Translational Allergy accepts clinical and translational research in the following areas and other related topics: asthma, rhinitis, rhinosinusitis, drug hypersensitivity, allergic conjunctivitis, allergic skin diseases, atopic eczema, urticaria, angioedema, venom hypersensitivity, anaphylaxis, food allergy, immunotherapy, immune modulators and biologics, animal models of allergic disease, immune mechanisms, or any other topic related to allergic disease.