Division of Allergy and Immunology, Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Ill; Department of Otolaryngology-Head and Neck Surgery, Feinberg School of Medicine, Northwestern University, Chicago, Ill.
Division of Allergy and Immunology, Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Ill.
J Allergy Clin Immunol Pract. 2021 Aug;9(8):3188-3195.e2. doi: 10.1016/j.jaip.2021.04.054. Epub 2021 May 24.
Whereas chronic rhinosinusitis (CRS) is associated with asthma, and vice versa, the association between CRS and other lower respiratory conditions is not well-established. Bronchiectasis is characterized by permanent damage of the airways, and as many as 45% of bronchiectasis patients have CRS, but the prevalence of bronchiectasis among CRS patients is not known.
To determine the prevalence of bronchiectasis among CRS patients and to characterize demographic and clinical features of patients with bronchiectasis and CRS.
Electronic medical records of patients with rhinosinusitis were searched by computer algorithm supplemented with manual chart review to identify patients with CRS, asthma, and/or bronchiectasis. Demographic and clinical features and antibiotic courses for sinopulmonary infections 2 years before and after sinus surgery were obtained by manual chart review.
The prevalence of bronchiectasis as determined by International Classification of Diseases, Ninth Revision code was significantly higher in CRS patients than in asthmatic patients (2.3% vs 1.7%; P < .003). Similarly, based on a text word search of "bronchiectasis" in the chest computed tomography (CT) scan reports, patients with CRS who had chest CT scans had a higher prevalence of bronchiectasis than did asthmatic patients with chest CT scans (24.3% vs 19.5%; P = .005). Patients with CRS and concurrent bronchiectasis did not have a reduction in the frequency of sinopulmonary infections after sinus surgery compared with patients with CRS without bronchiectasis (P < .05).
Bronchiectasis is an important comorbidity in patients with CRS and may identify a severe phenotype of chronic sinonasal disease.
慢性鼻-鼻窦炎（CRS）与哮喘有关，反之亦然，但 CRS 与其他下呼吸道疾病的关联尚未得到充分证实。支气管扩张症的特征是气道永久性损伤，多达 45%的支气管扩张症患者患有 CRS，但 CRS 患者中支气管扩张症的患病率尚不清楚。
确定 CRS 患者中支气管扩张症的患病率，并描述支气管扩张症和 CRS 患者的人口统计学和临床特征。
通过计算机算法搜索鼻-鼻窦炎患者的电子病历，并辅以手动图表审查，以确定患有 CRS、哮喘和/或支气管扩张症的患者。通过手动图表审查获取鼻窦手术后 2 年前和后鼻-肺感染的人口统计学和临床特征以及抗生素疗程。
通过国际疾病分类，第九版代码确定的支气管扩张症患病率在 CRS 患者中明显高于哮喘患者（2.3%比 1.7%；P<.003）。同样，根据胸部计算机断层扫描（CT）报告中“支气管扩张症”的文本词搜索，患有 CRS 且接受胸部 CT 扫描的患者的支气管扩张症患病率高于接受胸部 CT 扫描的哮喘患者（24.3%比 19.5%；P=.005）。与没有支气管扩张症的 CRS 患者相比，患有 CRS 且同时患有支气管扩张症的患者在鼻窦手术后，鼻-肺感染的频率并没有减少（P<.05）。
支气管扩张症是 CRS 患者的重要合并症，可能表明慢性鼻-鼻窦疾病的严重表型。
