Five-year risk of incident disease following a diagnosis of chronic rhinosinusitis.
Five-year risk of incident disease following a diagnosis of chronic rhinosinusitis.
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DOI：
10.1111/all.12759
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发表时间：
2015-12
期刊：
影响因子：
12.4
通讯作者：
Schwartz BS
中科院分区：
文献类型：
--
作者：
Hirsch AG;Yan XS;Sundaresan AS;Tan BK;Schleimer RP;Kern RC;Kennedy TL;Greene JS;Schwartz BS
慢性鼻-鼻窦炎(CRS)有多种并存疾病。由于缺乏纵向研究，目前尚不清楚这些共病是导致CRS的原因，还是由CRS促进的，还是与CRS共同的系统性疾病过程。确定在新诊断的CRS伴鼻息肉(CRSwNP)和不伴鼻息肉(CRSsNP)后五年内发生疾病的风险。我们使用电子健康记录数据在盖辛格诊所初级保健患者的纵向队列中进行了一项病例对照研究。我们使用多变量COX回归模型评估了新诊断的CRSwNP和CRSsNP病例与对照组相比5年内发生的疾病。CRSsNP(n=3612)的风险(HR，95%可信区间)高于对照组：上呼吸道疾病，包括扁桃体炎(3.29，2.41-4.50)；下呼吸道疾病，包括哮喘(2.69，2.14-3.38)；上皮性疾病，包括特应性皮炎(2.75，1.23-6.16)；高血压(1.38，1.19-1.61)。CRSwNP(n=241)的肥胖风险高于对照组(1.74，1.08-2.80)，但CRSwNP与其他疾病无关。与CRS相关的其他疾病的风险增加了本已高度负担的疾病的负担，并表明CRS要么促进了其他疾病的发生，要么是系统性疾病过程的指标。CRS表型与疾病的不同关联模式可能是由于CRSwNP样本大小的模拟，或者反映了表型疾病发病的不同模式。这些发现对CRS患者的筛查指南和护理具有一定的指导意义。
Chronic rhinosinusitis (CRS) has a broad range of co-morbidities. Due to a lack of longitudinal studies, it is not known whether these co-morbidities cause CRS, are promoted by CRS, or share a systemic disease process with CRS. To determine the risk of incident disease within five years after a new diagnosis of CRS with nasal polyps (CRSwNP) and without nasal polyps (CRSsNP). 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. 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. 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 imitations or reflect a different pattern of disease onset by phenotype. These findings have implications for screening guidelines and care of CRS patients.