Asia Pac Allergy.  2014 Oct;4(4):222-229. 10.5415/apallergy.2014.4.4.222.

The impact of sinusitis on the long-term clinical outcomes of asthma

• Kim MH
• Jung JW
• Cho SH
• Min KU
• Kang HR

• KMID: 2397103
• DOI: http://doi.org/10.5415/apallergy.2014.4.4.222

Abstract

BACKGROUND
Upper respiratory diseases have been linked with lower respiratory diseases. However, the long-term effect of sinusitis on the clinical outcomes of asthma has not been fully evaluated.
OBJECTIVE
The aim of this study was to investigate the impact of sinusitis on the disease progression of asthma.
METHODS
Seventy-five asthmatic patients confirmed with the methacholine bronchial provocation test or bronchodilator response were included. The study patients underwent paranasal sinus x-ray upon their asthma evaluation and they visited the hospital at least 3 years or longer. We retrospectively reviewed their medical records and compared data according to the presence of comorbid sinusitis.
RESULTS
Among the 75 asthmatic subjects, 38 subjects (50.7%) had radiologic evidence of sinusitis. Asthmatics with sinusitis had significantly lower forced expiratory volume in 1 second (FEV₁; 79.2% vs. 88.2%) and PC20 values (5.2 mg/mL vs. 8.9 mg/mL) compared to asthmatics without sinusitis at the time of diagnosis. This difference in FEV₁ disappeared (82.6% vs. 87.2%) in the 3-year follow-up, although FEV₁ was more variable (31.7% vs. 23.5%) and worst FEV₁ was also significantly lower in patients with sinusitis compared to those without (70.9% vs. 79.0%). There were no significant differences in the number of hospital visits, acute exacerbations, and scores for the asthma control test.
CONCLUSION
Although sinusitis was associated with lower baseline lung function and higher hyperreactivity, sinusitis was not related with significant deterioration in lung function over 3 years of follow-up. Asthmatics with sinusitis showed more variability in lung function during the follow-up period. Healthcare utilization was not different except antibiotics use.

Keyword

Sinusitis; Asthma; Disease progression; Forced expiratory volume

MeSH Terms

Anti-Bacterial Agents
Asthma*
Bronchial Provocation Tests
Delivery of Health Care
Diagnosis
Disease Progression
Follow-Up Studies
Forced Expiratory Volume
Humans
Lung
Medical Records
Methacholine Chloride
Retrospective Studies
Sinusitis*
Anti-Bacterial Agents
Methacholine Chloride

Figure

• 

  Fig. 1 Serial change in spirometric values after 3 years according to comorbid sinusitis in asthmatics patients. (A) Forced expiratory volume in 1 second (FEV1) predictive value was improved only in asthma patients with sinusitis; therefore, an initial gap between the sinusitis group and without sinusitis group disappeared after 3 years. (B) Best FEV1 predictive value during 3 years showed no difference between sinusitis group and without sinusitis group. (C) Asthma patients with sinusitis showed a lower FEV1 predictive value than those without sinusitis. (D) FEV1 variability was higher in asthma patients in the sinusitis group than in those in the sinusitis group. *p < 0.05, statistically significant.

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