Sinus inflammation and chronic rhinosinusitis are associated with a diagnosis of new onset asthma in the following year

Schwartz BS, Pollak JS, Bandeen-Roche K, Hirsch AG, Lehmann AE, Kern RC, Tan BK, Kato A, Schleimer RP, Peters AT. Allergy. 2023 May 17. doi: 10.1111/all.15771.

Abstract

Background

Chronic rhinosinusitis (CRS) and asthma commonly co-occur. No studies have leveraged large samples needed to formally address whether preexisting CRS is associated with new onset asthma over time.

Methods

We evaluated whether prevalent CRS (identified in two ways: validated text algorithm applied to sinus computerized tomography [CT] scan or two diagnoses) was associated with new onset adult asthma in the following year. We used electronic health record data from Geisinger in from 2008–2019. For each year we removed persons with any evidence of asthma through the end of the year, then identified those with new diagnosis of asthma in the following year.

Complementary log-log regression was used to adjust for confounding variables (e.g., sociodemographic, contact with the health system, co-morbidities), and hazard ratios (HR) and 95% confidence intervals (CI) were calculated.

Results

A total of 35,441 persons were diagnosed with new onset asthma and were compared to 890,956 persons who did not develop asthma. Persons with new onset asthma tended to be female (69.6%) and younger (mean [SD] age 45.9 [17.0] years). Both CRS definitions were associated (HR, 95% CI) with new onset asthma, with 2.21 (1.93, 2.54) and 1.48 (1.38, 1.59) for CRS based on sinus CT scan and two diagnoses, respectively. New onset asthma was uncommonly observed in persons with a history of sinus surgery.

Conclusion

Prevalent CRS identified with two complementary approaches was associated with a diagnosis of new onset asthma in the following year. The findings may have clinical implications for the prevention of asthma.

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