Nasal and sinus symptoms and chronic rhinosinusitis in a population-based sample.
Nasal and sinus symptoms and chronic rhinosinusitis in a population-based sample.
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DOI：
10.1111/all.13042
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发表时间：
2017-02
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;Stewart WF;Sundaresan AS;Young AJ;Kennedy TL;Scott Greene J;Feng W;Tan BK;Schleimer RP;Kern RC;Lidder A;Schwartz BS
本研究的目的是描述第一个基于美国的研究，使用欧洲鼻-鼻窦炎立场文件（EPOS）标准来研究一般人群样本中慢性鼻-鼻窦炎（CRS）的患病率。一份CRS症状问卷被邮寄给了来自Geisinger诊所的23,700名初级保健患者，Geisinger诊所是一个为宾夕法尼亚州45个县服务的卫生系统。CRS病例根据EPOS症状分为四个独特的亚组：阻塞和分泌物，无嗅觉丧失或疼痛/压力;嗅觉丧失，无疼痛/压力;面部疼痛和/或压力，无嗅觉丧失;嗅觉丧失和疼痛/压力。所有病例均要求有鼻塞或流涕。Logistic回归分析用于评估与CRS亚组相关的潜在因素。我们发现11.9%的患者符合CRS标准。50-59岁之间的患病率达到15.9%的高峰，69岁以后下降到6.8%。在白色、年轻、吸烟、有医疗救助史和患有其他疾病的患者中，CRS的几率更高。当CRS亚组单独建模时，这些关联对于某些CRS亚组不再显著。共病与报告嗅觉丧失和面部疼痛和/或压力的CRS病例相关性最强，与未报告这些症状的CRS病例相关性最弱。CRS是一种高度流行和异质性的疾病。症状亚组之间风险因素和健康结果的差异可能表明病因学的差异对疾病管理有影响。
The objective of this study was to describe the first US-based study to use the European Position Paper on Rhinosinusitis (EPOS) criteria to study the prevalence of chronic rhinosinusitis (CRS) in a general population sample. A CRS symptom questionnaire was mailed to 23,700 primary care patients from Geisinger Clinic, a health system serving 45 counties in Pennsylvania. CRS cases were categorized into four unique subgroups based on EPOS symptoms: obstruction and discharge with no smell loss or pain/pressure; smell loss without pain/pressure; facial pain and/or pressure without smell loss; and both smell loss and pain/pressure. All cases were required to have nasal obstruction or discharge. Logistic regression was used to evaluate potential factors associated with CRS subgroups. We found that 11.9% of patients met criteria for CRS. Prevalence peaked at 15.9% between ages 50–59 years and then dropped to 6.8% after age 69. The odds of CRS was higher among patients who were white, younger, smokers, had a history of Medical Assistance, and had other diseases. When CRS subgroups were modeled separately, these associations were no longer significant for some CRS subgroups. Co-morbid diseases were most strongly associated with CRS cases who reported smell loss and facial pain and/or pressure and had the weakest associations with CRS cases who did not report these symptoms. CRS is a highly prevalent and heterogeneous condition. Differences in risk factors and health outcomes across symptom subgroups may be indicative of differences in etiology that have implications for disease management.