Strong and consistent associations of precedent chronic rhinosinusitis with risk of non-cystic fibrosis bronchiectasis.
Strong and consistent associations of precedent chronic rhinosinusitis with risk of non-cystic fibrosis bronchiectasis.
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先例慢性鼻risis炎与非囊性纤维化支气管扩张的风险的紧密而一致的关联。
DOI：
10.1016/j.jaci.2022.03.006
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发表时间：
2022-09
影响因子：
14.2
通讯作者：
Peters, Anju T.
中科院分区：
文献类型：
--
作者：
Schwartz, Brian S.;Al-Sayouri, Saba A.;Pollak, Jonathan S.;Hirsch, Annemarie G.;Kern, Robert;Tan, Bruce;Kato, Atsushi;Schleimer, Robert P.;Peters, Anju T.
慢性鼻窦炎（CRS）和支气管扩张通常同时发生，但大多数先前的研究并没有设计来评估时间性和因果关系。在代表宾夕法尼亚州37个县的一般人群的样本中，因此，鼻窦和相关肺部疾病的全谱，我们评估了CRS与非囊性纤维化支气管扩张症相关性的时间性和强度。我们对三种原发性支气管扩张病例发现方法进行了病例对照分析。我们使用电子健康记录来识别CRS和支气管扩张症，包括诊断、程序命令和/或鼻窦或胸部计算机断层扫描（CT）中的特定文本。对照组从未有任何支气管扩张的迹象，并在年龄、性别和就诊年份上与三个支气管扩张组的频率相匹配。在三项分析中，有5，329名独特的支气管扩张症患者，33，363名没有支气管扩张症患者。重要的共同发生的条件与诊断，药物订单，和遇到的类型。Logistic回归用于评估CRS与支气管扩张的相关性（比值比[OR]，95%置信区间），同时调整混杂变量。在校正分析中，CRS与所有三种支气管扩张定义一致且强烈相关。根据鼻窦CT扫描文本，CRS的相关性（比值比，95%置信区间）最强，而无鼻息肉的CRS通常更强（例如，诊断为支气管扩张的OR = 4.46 [2.09，9.51]）。平均而言，CRS在支气管扩张症之前六年被发现。既往CRS与支气管扩张风险增加密切相关。鼻窦疾病的早期治疗可能为预防支气管扩张提供治疗策略。既往CRS与支气管扩张风险增加密切相关，因此早期治疗鼻窦疾病可能为预防支气管扩张提供治疗策略。
Chronic rhinosinusitis (CRS) and bronchiectasis commonly co-occur, but most prior studies were not designed to evaluate temporality and causality. In a sample representing the general population in 37 counties in Pennsylvania, and thus the full spectrum of sinonasal and relevant lung diseases, we evaluated temporality and strength of associations of CRS with non-cystic fibrosis bronchiectasis. We completed case-control analyses for each of three primary bronchiectasis case finding methods. We used electronic health records to identify CRS and bronchiectasis with diagnoses, procedure orders, and/or specific text in sinus or chest computerized tomography (CT) scans. Controls never had any indication of bronchiectasis and were frequency-matched to the three bronchiectasis groups on age, sex, and encounter year. There were 5,329 unique persons with bronchiectasis and 33,363 without in the three analyses. Important co-occurring conditions were identified with diagnoses, medication orders, and encounter types. Logistic regression was used to evaluate associations (odds ratios [OR], 95% confidence intervals) of CRS with bronchiectasis while adjusting for confounding variables. In adjusted analyses, CRS was consistently and strongly associated with all three bronchiectasis definitions. Associations (odds ratio, 95% confidence interval) were strongest for CRS based on sinus CT scan text and were generally stronger for CRS without nasal polyps (e.g., OR = 4.46 [2.09, 9.51] for diagnosis-based bronchiectasis). On average, CRS was identified over six years before bronchiectasis. Precedent CRS was strongly and consistently associated with increased risk of bronchiectasis. Early treatment of sinonasal disease may offer therapeutic strategies for prevention of bronchiectasis. Precedent CRS was strongly and consistently associated with increased risk of bronchiectasis, so early treatment of sinonasal disease may offer therapeutic strategies for prevention of bronchiectasis.
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