Agnes S Sundaresan1, Annemarie G Hirsch2, Amanda J Young2, Jonathan Pollak3, Bruce K Tan4, Robert P Schleimer4, Robert C Kern4, Thomas L Kennedy5, J Scott Greene5, Walter F Stewart6, Karen Bandeen-Roche7, Brian S Schwartz8. 1. Department of Epidemiology and Health Services Research, Geisinger Health System, Danville, Pa. Electronic address: ashsundaresan@geisinger.edu. 2. Department of Epidemiology and Health Services Research, Geisinger Health System, Danville, Pa. 3. Department of Environmental Health and Engineering, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Md. 4. Department of Otolaryngology Head and Neck Surgery and the Division of Allergy and Immunology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Ill. 5. Department of Otolaryngology/Head and Neck/Facial Plastic Surgery, Geisinger Health System, Danville, Pa. 6. Sutter Health, Walnut Creek, Calif. 7. Department of Biostatistics, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Md. 8. Department of Epidemiology and Health Services Research, Geisinger Health System, Danville, Pa; Department of Environmental Health and Engineering, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Md.
Abstract
BACKGROUND: Chronic rhinosinusitis (CRS) is a prevalent and disabling condition of the nose and sinuses. The natural history of CRS symptoms in a general population sample has not been previously studied. OBJECTIVE: In a general population-based sample from Pennsylvania, we used 2 questionnaires mailed 6 months apart to estimate the prevalence of, and identify predictors for, stability or change in symptoms over time. METHODS: We mailed the baseline and 6-month follow-up questionnaires to 23,700 primary care patients and 7,801 baseline responders, respectively. We categorized nasal and sinus symptoms using European Position Paper on Rhinosinusitis (EPOS) epidemiologic criteria. We defined 6 symptom groups over time on the basis of the presence of CRS symptoms at baseline and follow-up. We performed multivariable survey logistic regression controlling for confounding variables comparing persistent versus nonpersistent, recurrent versus stable past, and incident versus never. RESULTS: There were 4,966 responders at follow-up: 558 had persistent symptoms, 190 recurrent symptoms, and 83 new symptoms meeting EPOS criteria for CRS. The prevalence of persistent symptoms was 4.8% (95% CI, 3.8-5.8), whereas the annual cumulative incidence of new symptoms was 1.9% and of recurrent symptoms was 3.2%. More severe symptoms at baseline were associated with persistence, whereas minor symptoms, allergies, and multiple treatments were associated with the development of new symptoms. CONCLUSIONS: Less than half with nasal and sinus symptoms meeting CRS EPOS criteria in our general, regional population had symptom persistence over time, with symptom profiles at baseline and age of onset being strongly associated with stability of symptoms.
BACKGROUND:Chronic rhinosinusitis (CRS) is a prevalent and disabling condition of the nose and sinuses. The natural history of CRS symptoms in a general population sample has not been previously studied. OBJECTIVE: In a general population-based sample from Pennsylvania, we used 2 questionnaires mailed 6 months apart to estimate the prevalence of, and identify predictors for, stability or change in symptoms over time. METHODS: We mailed the baseline and 6-month follow-up questionnaires to 23,700 primary care patients and 7,801 baseline responders, respectively. We categorized nasal and sinus symptoms using European Position Paper on Rhinosinusitis (EPOS) epidemiologic criteria. We defined 6 symptom groups over time on the basis of the presence of CRS symptoms at baseline and follow-up. We performed multivariable survey logistic regression controlling for confounding variables comparing persistent versus nonpersistent, recurrent versus stable past, and incident versus never. RESULTS: There were 4,966 responders at follow-up: 558 had persistent symptoms, 190 recurrent symptoms, and 83 new symptoms meeting EPOS criteria for CRS. The prevalence of persistent symptoms was 4.8% (95% CI, 3.8-5.8), whereas the annual cumulative incidence of new symptoms was 1.9% and of recurrent symptoms was 3.2%. More severe symptoms at baseline were associated with persistence, whereas minor symptoms, allergies, and multiple treatments were associated with the development of new symptoms. CONCLUSIONS: Less than half with nasal and sinus symptoms meeting CRS EPOS criteria in our general, regional population had symptom persistence over time, with symptom profiles at baseline and age of onset being strongly associated with stability of symptoms.
Authors: Bruce K Tan; Rakesh K Chandra; Jonathan Pollak; Atsushi Kato; David B Conley; Anju T Peters; Leslie C Grammer; Pedro C Avila; Robert C Kern; Walter F Stewart; Robert P Schleimer; Brian S Schwartz Journal: J Allergy Clin Immunol Date: 2013-03-28 Impact factor: 10.793
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Authors: R B Lipton; D Dodick; R Sadovsky; K Kolodner; J Endicott; J Hettiarachchi; W Harrison Journal: Neurology Date: 2003-08-12 Impact factor: 9.910
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Authors: M Cole; K Bandeen-Roche; A G Hirsch; J R Kuiper; A S Sundaresan; B K Tan; R P Schleimer; R C Kern; B S Schwartz Journal: Allergy Date: 2018-05-21 Impact factor: 13.146
Authors: Annemarie G Hirsch; Cara Nordberg; Karen Bandeen-Roche; Bruce K Tan; Robert P Schleimer; Robert C Kern; Agnes Sundaresan; Jayant M Pinto; Thomas L Kennedy; Joseph Scott Greene; Jordan R Kuiper; Brian S Schwartz Journal: Allergy Date: 2019-12-02 Impact factor: 13.146
Authors: Jordan R Kuiper; Annemarie G Hirsch; Karen Bandeen-Roche; Agnes S Sundaresan; Bruce K Tan; Robert C Kern; Robert P Schleimer; Brian S Schwartz Journal: PLoS One Date: 2020-06-29 Impact factor: 3.240
Authors: Eugenio De Corso; Silvia Baroni; Stefano Settimi; Maria Elisabetta Onori; Rodolfo Francesco Mastrapasqua; Eliana Troiani; Giacomo Moretti; Donatella Lucchetti; Marco Corbò; Claudio Montuori; Alessandro Cantiani; Davide Paolo Porru; Simone Lo Verde; Giuseppe Alberto Di Bella; Cristiano Caruso; Jacopo Galli Journal: J Pers Med Date: 2022-07-29