This longitudinal study included 14,762 individuals with CRS from the Korean National Health Insurance Service database, on whom data were collected between 2002 and 2013. Those with CRS were matched with a comparison group of 29,524 individuals without CRS from the database through 1:2 nearest-neighbor propensity score matching, which accounted for enrollment year, age, household income, and residential area. During a follow-up of 11-years, individuals were monitored for all-cause mortality, stroke, anxiety disorder, depression, acute MI, and asthma, which composed the study end points. Risks for these conditions were compared between the CRS and comparison groups, with the Cox proportional hazards model used to calculate hazard ratios (HRs).
Compared with patients without CRS, those with CRS had a higher incidence of asthma (71.1 vs 35.6 per 1000 person-years; adjusted HR, 2.06; 95% CI, 2.00-2.13), acute MI (3.1 vs 2.4 per 1000 person-years; adjusted HR, 1.29; 95% CI, 1.15-1.44), stroke (7.7 vs 6.5 per 1000 person-years; adjusted HR, 1.16; 95% CI, 1.08-1.24), anxiety disorder (42.1 vs 28.0 per 1000 person-years; HR, 1.54; 95% CI, 1.49-1.60), and depression (24.2 vs 16.2 per 1000 person-years; HR, 1.50; 95% CI, 1.44-1.57).
Limitations to these findings included a cross-sectional or cohort or design among the included studies and short periods of observation.
The study researchers concluded that “patients with CRS had a higher risk for comorbid conditions during an 11-year follow-up period.” Clinicians treating individuals with CRS should be attentive to “the increased risk of developing asthma, [acute] MI, stroke, and mental health problems” and should take measures to decrease the risk for these common comorbidities.
Kim J-Y, Ko I, Kim MS, Kim DW, Cho B-J, Kim D-K. Relationship of chronic rhinosinusitis with asthma, myocardial infarction, stroke, anxiety, and depression [published online September 18, 2019]. J Allergy Clin Immunol Pract. doi:10.1016/j.jaip.2019.09.001