1 Department of Otorhinolaryngology, Yonsei University Wonju College of Medicine, Wonju, South Korea.
2 Department of Research Affairs, Biostatistics Collaboration Unit, Yonsei University College of Medicine, Seoul, South Korea.
Am J Rhinol Allergy. 2019 May;33(3):240-246. doi: 10.1177/1945892418813822. Epub 2018 Nov 28.
Although a significant number of the clinical features and pathophysiologic mechanisms of chronic rhinosinusitis (CRS) have been described, only a few studies have been published on characterization of CRS in the field of aging.
We investigated the prevalence and risk factors of CRS in elderly (≥65 years old) Koreans using large-scale nationwide epidemiological data and compared the risk factors of elderly with those of younger adult participants (19-64 years old).
Data from 25 529 participants who completed the 2008-2012 Korean National Health and Nutrition Examination Survey were analyzed. Diagnosis of CRS was done according to the EP3OS 2012 guideline for epidemiologic study. Risk factors of CRS were compared in the aspects of sociodemographics, general health behaviors, clinical characteristics, and comorbidities of participants.
The prevalence of CRS was significantly higher in 5590 elderly than in 19 939 younger adults (6.55% vs 5.69%; P = .016. Some variables of socioeconomic status and mental health in the adult group were associated with increased risk of CRS but did not show association in the elderly group. We observed a significant association between CRS prevalence and comorbid allergic rhinitis, asthma, and atopic dermatitis in both groups ( P < .05). However, in the elderly group, the associations were significantly weaker with regard to allergic rhinitis ( P-interaction = .03) and asthma ( P-interaction = .002).
These results suggest that elderly populations have distinct pathophysiology and clinical presentations from adult CRS, and management for elderly patients with CRS may require different or additional therapeutic approaches.
虽然慢性鼻-鼻窦炎(CRS)的许多临床特征和病理生理机制已经被描述,但在老龄化领域对 CRS 的特征研究仅有少数报道。
我们利用大规模的全国性流行病学数据,研究了韩国老年人(≥65 岁)CRS 的患病率和危险因素,并将老年人与年轻成年参与者(19-64 岁)的危险因素进行了比较。
对完成 2008-2012 年韩国国家健康和营养调查的 25529 名参与者的数据进行了分析。根据 EP3OS 2012 年流行病学研究指南对 CRS 进行诊断。比较了参与者在社会人口统计学、一般健康行为、临床特征和合并症方面的 CRS 危险因素。
5590 名老年人的 CRS 患病率明显高于 19939 名年轻成年人(6.55%比 5.69%;P = .016)。在成年组中,一些社会经济地位和心理健康相关变量与 CRS 风险增加有关,但在老年组中则没有关联。我们观察到两组中 CRS 患病率与合并变应性鼻炎、哮喘和特应性皮炎均显著相关(P < .05)。然而,在老年组中,变应性鼻炎(P 交互 = .03)和哮喘(P 交互 = .002)的相关性显著减弱。
这些结果表明,老年人群的病理生理学和临床表现与成人 CRS 不同,老年 CRS 患者的管理可能需要不同或额外的治疗方法。