Seasonal variations of hospitalizations for chronic rhinosinusitis by different endotypes
Year: 2022
Type: conference-abstract
Abstract: Background/aim: chronic rhinosinusitis (CRS) affects ~12% of the population and costs ~$30 billion each year in the US. A recent study reported winter and spring exacerbations of sinonasal symptoms among CRS patients; however, little is known about seasonal exacerbations by endotypes. This study aims to investigate seasonal variations of CRS hospitalizations among different inflammatory endotypes. Methods: CRS patients with different endotypes were identified in Mount Sinai electronic health records using a multi-layer CRS phenotyping algorithm integrating features such as encounter frequencies, surgeries, provider specialties and biomarkers, which was previously evaluated with high prediction performance (PPV=0.91). The patients with hospitalizations from 2003-2019 were included while patients with comorbidities of asthma or allergic rhinitis were excluded. Quasi-Poisson regression models were used to evaluate the associations between seasons and daily counts of CRS hospitalizations, adjusting for long-term temporal trend, day-of-the-week, daily temperature and PM2.5. Results: The counts of CRS hospitalizations were 32,194 in spring, 31,993 in summer, 32,077 in fall, and 30,584 in winter. For all CRS patients, no significant differences by season were detected. Among patients with nasal polyps (1615/7604), the highest risk of hospitalization was seen in spring (RR: 1.11; 95% CI: 1.06-1.17), followed by fall (RR: 1.06; 95% CI: 1.01-1.12), compared to winter. Similar patterns were observed in patients with blood eosinophil count > 300 cells/mcL (596/7604): increased risks of hospitalization were observed in spring (RR: 1.10; 95% CI: 1.04-1.16) and fall (RR: 1.08; 95% CI: 1.01, 1.14). In contrast, no differences by season were found for CRS patients without nasal polyps or with low eosinophil count. Conclusions: Elevated risks of hospitalizations in spring and fall were only observed in CRS patients with endotypes related to eosinophilic type 2 inflammation. The high recurrence and refractory nature of these endotypes might be attributable to seasonal environmental factors. Keywords: rhinosinusitis, seasonal exacerbations
Source: ISEE Conference Abstracts
Language: English
Subfield: Otorhinolaryngology
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W4317182274