The following is a summary of “Associations between chronic rhinosinusitis and the development of non-cystic fibrosis bronchiectasis,” published in the August 2024 issue of Allergy and Immunology by Kim et al.
Recent studies have established a potential link between chronic rhinosinusitis (CRS) and the subsequent development of non-cystic fibrosis (CF) bronchiectasis. This study aimed to investigate whether CRS increases the risk of developing non-CF bronchiectasis, with a particular focus on differentiating risks among patients with and without coexisting respiratory conditions such as asthma and chronic obstructive pulmonary disease (COPD).
To achieve this, a retrospective analysis was conducted using electronic medical records from an academic medical center. The study included patients diagnosed with CRS who had no prior history of bronchiectasis and had undergone at least one chest computed tomography (CT) scan after their CRS diagnosis, identified between January 2006 and December 2015. Patient records were reviewed through May 2022. A control group, matched by age, sex, and race, was also established, comprising individuals without CRS, asthma, or COPD, who had similarly undergone at least one chest CT scan. The primary outcome was the development of bronchiectasis, as identified through chest CT radiology reports. The analysis was further divided into two cohorts: Cohort 1 consisted of patients with CRS without asthma or COPD, and Cohort 2 included patients with CRS and concurrent asthma or COPD.
The findings revealed that patients with CRS had a significantly higher likelihood of developing bronchiectasis (139 out of 1,594 patients, 8.7%) compared to the control group (443 out of 7,992 patients, 5.5%), with an odds ratio (OR) of 1.63 [95% CI 1.34-1.99]. Specifically, in Cohort 1, the odds of developing bronchiectasis were 7.3% (63 out of 863 patients, OR 1.34 [95% CI 1.02-1.76]), while in Cohort 2, the odds were notably higher at 10.4% (76 out of 731 patients, OR 1.98 [95% CI 1.53-2.55]). After adjusting for potential confounding variables, the association between CRS and bronchiectasis remained significant in Cohort 2 (OR 1.78 [95% CI 1.37-2.31]), though it was attenuated in Cohort 1 (OR 1.22 [95% CI 0.92-1.61]).
In conclusion, CRS is strongly associated with an increased risk of developing non-CF bronchiectasis, particularly among patients who also have asthma or COPD. These findings underscore the importance of vigilant respiratory monitoring in patients with CRS, especially those with existing respiratory comorbidities, to enable early detection and intervention in the development of bronchiectasis.
Source: sciencedirect.com/science/article/abs/pii/S2213219824007773