Risk of new onset and prevalent disease in chronic rhinosinusitis: a prospective cohort study.

BACKGROUND: Chronic rhinosinusitis (CRS) is accompanied by burdensome co-morbid conditions. Understanding the relative timing of these conditions' onset could inform disease prevention, detection, and management.

OBJECTIVE: To evaluate the association between CRS and new onset and prevalent asthma, non-cystic fibrosis bronchiectasis (NCFBE), chronic obstructive pulmonary disease (COPD), gastroesophageal reflux disease (GERD), and obstructive sleep apnea (OSA).

METHODS: We conducted a prospective cohort study among primary care patients using a detailed medical and symptom questionnaire in 2014 and again in 2020. We used questionnaire and electronic health record (EHR) data to determine CRS status: CRSSE (moderate to severe symptoms with EHR evidence), CRSE (limited symptoms with EHR evidence), CRSS (moderate to severe symptoms without EHR evidence), CRSneg (limited symptoms and no EHR evidence; reference). We evaluated the association between CRS status and new onset and prevalent disease using logistic regression to estimate odds ratios (OR) and 95% confidence intervals (CI).

RESULTS: There were 7,847 and 4,445 respondents to the 2014 and 2020 questionnaires, respectively. CRSSE (versus CRSneg ) was associated with increased odds of new onset asthma (OR:1.74; CI:1.09, 2.77), NCFBE (OR:1.87, CI:1.12, 3.13), COPD (OR:1.73; CI:1.14, 2.68), GERD (OR:1.95, CI:1.61, 2.35), and OSA (OR:1.91; CI:1.39, 2.62). Similarly increased odds were observed for associations with the prevalence of these conditions.

CONCLUSION: The findings from the study support further exploration of CRS as a target for the prevention and detection of asthma, NCFBE, COPD, GERD, and OSA. This article is protected by copyright. All rights reserved.