Risk factors associated with comorbid asthma in patients with chronic rhinosinusitis with nasal polyps: a cross-sectional study

Abstract

Background Although 20–60% of patients with chronic rhinosinusitis with nasal polyps (CRSwNP) have asthma, the risk factors associated with comorbid asthma are not clear. The aim of the study was to investigate the factors associated with asthma, and develop a practical scoring system to screen asthma comorbidity in CRSwNP patients. Methods This report describes a cross-sectional study with consecutive CRSwNP patients. Two cohorts of CRSwNP patients named “modelling” group and “validation” group were investigated respectively. Logistic regression analysis was performed based on demographic and clinical data collected from patients in the modelling group to determine the risk factors associated with asthma, and establish a scoring system for screening comorbid asthma. Receiver operating characteristic curve was constructed to evaluate the screening system; the optimal cut-off point was established by means of the Yoden Index. The consistency between the diagnosis of asthma by the Global Initiative for Asthma (GINA) criteria and by the screening system was assessed by Kappa value in the validation group. Results Totally 150 patients in modelling group and 78 patients in validation group were enrolled. Female gender (odds ratio [OR] = 6.4; P < 0.001), allergic rhinitis (OR = 2.9; P = 0.021), serum total (T)-immunoglobulin (Ig) E ≥ 69.0kU/L (OR = 12.0; P < 0.001), and blood eosinophil count ≥ 0.35 × 109/L (OR = 4.0; P = 0.001) were shown to be independent risk factors for asthma in patients with CRSwNP. Based on these variables, a scoring system (FAIE) ranging from 0(no risk) to 6(high risk); was developed. The area under the receiver operating characteristic curve of the system was 0.823, and the optimal cut-off value was 3 points, with sensitivity 83.8% and specificity 68.6% for screening asthma. The asthma comorbidity determined with FAIE score ≥ 3 points in the validation group, was moderately consistent with that defined by GINA (Kappa = 0.513, P < 0.001), with sensitivity 76.9% and specificity 74.4%. Conclusions Female gender, allergic rhinitis, serum T-IgE level, and blood eosinophil count are independent risk factors for asthma comorbidity in patients with CRSwNP, and the FAIE system may be practical for screening comorbid asthma in these patients.

Decreased FEF50 as an indicator of comorbid asthma and persistent airflow limitation in patients with chronic rhinosinusitis with nasal polyps: A cross-sectional study

“…The ndings of the study have additionally shown that except for underdiagnosed, asthma in patients with CRSwNP is more severe than those without CRSwNP, emphasizing that it is important to early identify, monitor and treat comorbid asthma in CRSwNP patients. Although we have previously demonstrated that a scoring system based on female gender, history of AR, increased blood EOS, and IgE levels (FAIE) is useful for screening comorbid asthma in patients with CRSwNP, [4] the current ndings suggest that a decreased FEF 50 may be superior to the FAIE system in this respect. As decreased perception of asthma symptoms and BD reversibility test, which is prone to be negative, are the main indicators of underdiagnosis of comorbid asthma in CRSwNP patients, [4] we suggest that determination of variable air ow limitation in patients with CRSwNP is probably better based on an improvement of FEV 1 after anti-in ammatory treatment, especially in suspected asthmatics with FEF 50 %pred <60% and poor response to short-acting beta 2-agonists.…”

“…Although we have previously demonstrated that a scoring system based on female gender, history of AR, increased blood EOS, and IgE levels (FAIE) is useful for screening comorbid asthma in patients with CRSwNP, [4] the current ndings suggest that a decreased FEF 50 may be superior to the FAIE system in this respect. As decreased perception of asthma symptoms and BD reversibility test, which is prone to be negative, are the main indicators of underdiagnosis of comorbid asthma in CRSwNP patients, [4] we suggest that determination of variable air ow limitation in patients with CRSwNP is probably better based on an improvement of FEV 1 after anti-in ammatory treatment, especially in suspected asthmatics with FEF 50 %pred <60% and poor response to short-acting beta 2-agonists. Decreased FEF 50 as an indicator of PAL also suggests that monitoring FEF 50 should be helpful for the assessment of asthma control and medication adjustment in asthmatics with comorbid CRSwNP.…”

“…For indicator assessment, the sample size for each group was determined to be at least 10 times the number of indicators. [ 4 ] Data were expressed as mean ± standard deviation (for normal distribution parameters) or as median and 25th–75th percentiles (for abnormal distribution parameters). The t -test or Mann–Whitney U test was used to compare continuous data between different groups.…”

Fatores de riscos respiratórios e cuidado integral ao paciente asmático

“…Os desfechos do estudo mostraram o sexo feminino e a rinite alérgica como fator etiológico independete pra asma. A rinite alérgica pode ser determinada por características clínicas típicas como rinorreia, espirros, obstrução e prurido e sensibilidade a pelo menos um aeroalérgeno comum ácaros e pólen, por exemplo (Li et al, 2022). Os níveis séricos de IgE total e a contagem de eosinófilos no sangue também foram associados ao risco para a asma em pacientes com RSCcPN.…”

Allergen Sensitization in Children in Weifang, China: Differences Between Monosensitization and Polysensitization

“…Therefore, the aim of this study was to describe the pattern profile of monosensitization and polysensitization for common allergens in 938 IgE-positive children. Increasing evidence suggests that elevated levels of total serum IgE (T-IgE) 9 and eosinophils 10 are linked to allergic illnesses, although the underlying patterns remain elusive. In this study, intrinsic features such as age, gender, sIgE, and T-IgE and clinical parameters such as the eosinophil percentage, eosinophil count, basophil percentage, and basophil count were compared between children with monosensitization and those with polysensitization.…”