Five-year risk of incident disease following a diagnosis of chronic rhinosinusitis

A. G. Hirsch, X. S. Yan, A. S. Sundaresan, B. K. Tan, R. P. Schleimer, R. C. Kern, T. L. Kennedy, J. S. Greene, Brian S Schwartz

Research output: Contribution to journalArticle

Abstract

Background Chronic rhinosinusitis (CRS) has a broad range of comorbidities. Due to a lack of longitudinal studies, it is not known whether these comorbidities cause CRS, are promoted by CRS, or share a systemic disease process with CRS. Objective The objective of this study was to determine the risk of incident disease within 5 years after a new diagnosis of CRS with nasal polyps (CRSwNP) and without nasal polyps (CRSsNP). Methods We conducted a case-control study nested within the longitudinal cohort of primary care patients in the Geisinger Clinic using electronic health record data. We evaluated incident disease over 5 years in newly diagnosed CRSwNP and CRSsNP cases compared to controls using multivariable Cox regression models. Results CRSsNP (n = 3612) cases were at greater risk (HR, 95% confidence interval) than controls for incidence of: upper airway diseases, including adenotonsillitis (3.29, 2.41-4.50); lower aerodigestive tract diseases, including asthma (2.69, 2.14-3.38); epithelial conditions, including atopic dermatitis (2.75, 1.23-6.16); and hypertension (1.38, 1.19-1.61). CRSwNP (n = 241) cases were at greater risk for obesity than controls (1.74, 1.08-2.80), but CRSwNP was not associated with other diseases. Conclusion The risk of other diseases associated with CRS adds to the burden of an already highly burdensome condition, and suggests either that CRS promotes onset of other diseases or is an indicator of systemic disease processes. Different patterns of association with diseases by CRS phenotype may be due to CRSwNP sample size limitations or reflect a different pattern of disease onset by phenotype. These findings have implications for screening guidelines and care of CRS patients.

Original languageEnglish (US)
Pages (from-to)1613-1621
Number of pages9
JournalAllergy: European Journal of Allergy and Clinical Immunology
Volume70
Issue number12
DOIs
StatePublished - Dec 1 2015

Fingerprint

Nasal Polyps
Comorbidity
Phenotype
Electronic Health Records
Atopic Dermatitis
Proportional Hazards Models
Sample Size
Longitudinal Studies
Case-Control Studies
Primary Health Care
Chronic Disease
Asthma
Obesity
Guidelines
Confidence Intervals
Hypertension
Incidence

Keywords

  • CRS
  • epidemiology
  • nasal polyps

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology

Cite this

Five-year risk of incident disease following a diagnosis of chronic rhinosinusitis. / Hirsch, A. G.; Yan, X. S.; Sundaresan, A. S.; Tan, B. K.; Schleimer, R. P.; Kern, R. C.; Kennedy, T. L.; Greene, J. S.; Schwartz, Brian S.

In: Allergy: European Journal of Allergy and Clinical Immunology, Vol. 70, No. 12, 01.12.2015, p. 1613-1621.

Research output: Contribution to journalArticle

Hirsch, AG, Yan, XS, Sundaresan, AS, Tan, BK, Schleimer, RP, Kern, RC, Kennedy, TL, Greene, JS & Schwartz, BS 2015, 'Five-year risk of incident disease following a diagnosis of chronic rhinosinusitis', Allergy: European Journal of Allergy and Clinical Immunology, vol. 70, no. 12, pp. 1613-1621. https://doi.org/10.1111/all.12759
Hirsch, A. G. ; Yan, X. S. ; Sundaresan, A. S. ; Tan, B. K. ; Schleimer, R. P. ; Kern, R. C. ; Kennedy, T. L. ; Greene, J. S. ; Schwartz, Brian S. / Five-year risk of incident disease following a diagnosis of chronic rhinosinusitis. In: Allergy: European Journal of Allergy and Clinical Immunology. 2015 ; Vol. 70, No. 12. pp. 1613-1621.
@article{5abac08fb0f347c3935eb836dc91391b,
title = "Five-year risk of incident disease following a diagnosis of chronic rhinosinusitis",
abstract = "Background Chronic rhinosinusitis (CRS) has a broad range of comorbidities. Due to a lack of longitudinal studies, it is not known whether these comorbidities cause CRS, are promoted by CRS, or share a systemic disease process with CRS. Objective The objective of this study was to determine the risk of incident disease within 5 years after a new diagnosis of CRS with nasal polyps (CRSwNP) and without nasal polyps (CRSsNP). Methods We conducted a case-control study nested within the longitudinal cohort of primary care patients in the Geisinger Clinic using electronic health record data. We evaluated incident disease over 5 years in newly diagnosed CRSwNP and CRSsNP cases compared to controls using multivariable Cox regression models. Results CRSsNP (n = 3612) cases were at greater risk (HR, 95{\%} confidence interval) than controls for incidence of: upper airway diseases, including adenotonsillitis (3.29, 2.41-4.50); lower aerodigestive tract diseases, including asthma (2.69, 2.14-3.38); epithelial conditions, including atopic dermatitis (2.75, 1.23-6.16); and hypertension (1.38, 1.19-1.61). CRSwNP (n = 241) cases were at greater risk for obesity than controls (1.74, 1.08-2.80), but CRSwNP was not associated with other diseases. Conclusion The risk of other diseases associated with CRS adds to the burden of an already highly burdensome condition, and suggests either that CRS promotes onset of other diseases or is an indicator of systemic disease processes. Different patterns of association with diseases by CRS phenotype may be due to CRSwNP sample size limitations or reflect a different pattern of disease onset by phenotype. These findings have implications for screening guidelines and care of CRS patients.",
keywords = "CRS, epidemiology, nasal polyps",
author = "Hirsch, {A. G.} and Yan, {X. S.} and Sundaresan, {A. S.} and Tan, {B. K.} and Schleimer, {R. P.} and Kern, {R. C.} and Kennedy, {T. L.} and Greene, {J. S.} and Schwartz, {Brian S}",
year = "2015",
month = "12",
day = "1",
doi = "10.1111/all.12759",
language = "English (US)",
volume = "70",
pages = "1613--1621",
journal = "Allergy: European Journal of Allergy and Clinical Immunology",
issn = "0105-4538",
publisher = "Wiley-Blackwell",
number = "12",

}

TY - JOUR

T1 - Five-year risk of incident disease following a diagnosis of chronic rhinosinusitis

AU - Hirsch, A. G.

AU - Yan, X. S.

AU - Sundaresan, A. S.

AU - Tan, B. K.

AU - Schleimer, R. P.

AU - Kern, R. C.

AU - Kennedy, T. L.

AU - Greene, J. S.

AU - Schwartz, Brian S

PY - 2015/12/1

Y1 - 2015/12/1

N2 - Background Chronic rhinosinusitis (CRS) has a broad range of comorbidities. Due to a lack of longitudinal studies, it is not known whether these comorbidities cause CRS, are promoted by CRS, or share a systemic disease process with CRS. Objective The objective of this study was to determine the risk of incident disease within 5 years after a new diagnosis of CRS with nasal polyps (CRSwNP) and without nasal polyps (CRSsNP). Methods We conducted a case-control study nested within the longitudinal cohort of primary care patients in the Geisinger Clinic using electronic health record data. We evaluated incident disease over 5 years in newly diagnosed CRSwNP and CRSsNP cases compared to controls using multivariable Cox regression models. Results CRSsNP (n = 3612) cases were at greater risk (HR, 95% confidence interval) than controls for incidence of: upper airway diseases, including adenotonsillitis (3.29, 2.41-4.50); lower aerodigestive tract diseases, including asthma (2.69, 2.14-3.38); epithelial conditions, including atopic dermatitis (2.75, 1.23-6.16); and hypertension (1.38, 1.19-1.61). CRSwNP (n = 241) cases were at greater risk for obesity than controls (1.74, 1.08-2.80), but CRSwNP was not associated with other diseases. Conclusion The risk of other diseases associated with CRS adds to the burden of an already highly burdensome condition, and suggests either that CRS promotes onset of other diseases or is an indicator of systemic disease processes. Different patterns of association with diseases by CRS phenotype may be due to CRSwNP sample size limitations or reflect a different pattern of disease onset by phenotype. These findings have implications for screening guidelines and care of CRS patients.

AB - Background Chronic rhinosinusitis (CRS) has a broad range of comorbidities. Due to a lack of longitudinal studies, it is not known whether these comorbidities cause CRS, are promoted by CRS, or share a systemic disease process with CRS. Objective The objective of this study was to determine the risk of incident disease within 5 years after a new diagnosis of CRS with nasal polyps (CRSwNP) and without nasal polyps (CRSsNP). Methods We conducted a case-control study nested within the longitudinal cohort of primary care patients in the Geisinger Clinic using electronic health record data. We evaluated incident disease over 5 years in newly diagnosed CRSwNP and CRSsNP cases compared to controls using multivariable Cox regression models. Results CRSsNP (n = 3612) cases were at greater risk (HR, 95% confidence interval) than controls for incidence of: upper airway diseases, including adenotonsillitis (3.29, 2.41-4.50); lower aerodigestive tract diseases, including asthma (2.69, 2.14-3.38); epithelial conditions, including atopic dermatitis (2.75, 1.23-6.16); and hypertension (1.38, 1.19-1.61). CRSwNP (n = 241) cases were at greater risk for obesity than controls (1.74, 1.08-2.80), but CRSwNP was not associated with other diseases. Conclusion The risk of other diseases associated with CRS adds to the burden of an already highly burdensome condition, and suggests either that CRS promotes onset of other diseases or is an indicator of systemic disease processes. Different patterns of association with diseases by CRS phenotype may be due to CRSwNP sample size limitations or reflect a different pattern of disease onset by phenotype. These findings have implications for screening guidelines and care of CRS patients.

KW - CRS

KW - epidemiology

KW - nasal polyps

UR - http://www.scopus.com/inward/record.url?scp=84969169828&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84969169828&partnerID=8YFLogxK

U2 - 10.1111/all.12759

DO - 10.1111/all.12759

M3 - Article

C2 - 26332371

AN - SCOPUS:84969169828

VL - 70

SP - 1613

EP - 1621

JO - Allergy: European Journal of Allergy and Clinical Immunology

JF - Allergy: European Journal of Allergy and Clinical Immunology

SN - 0105-4538

IS - 12

ER -