Chronic Obstructive Pulmonary Disease Is Negatively Related with Nasal Polyp in Middle Aged and Elderly Chronic Rhinosinusitis Patients

Abstract Background: Prevalence and impact of chronic rhinosinusitis (CRS) in chronic obstructive pulmonary disease (COPD) remain unclear. We hypothesized that CRS is more frequent in patients with COPD compared to controls and we aimed to evaluate the odds of CRS in both groups. Methods: We recruited patients with COPD and a healthy control group in a tertiary referral hospital in Switzerland. Diagnosis of CRS was defined according to published guidelines and supported by computed tomography (CT) findings. Sino-nasal-outcome-test-20 (SNOT-20) and sino-nasal-outcome-test-primary-nasal-symptom-score (SNOT-PNS-score) were self-assessed with a cut-off for abnormality of >12. Results: Data from 83 COPD patients (35 females, age: 67 years ± 10) and 34 controls (18 females, age: 67 years ± 12) were analyzed. In the COPD group 14 out of 83 (20.3%) fulfilled the diagnosis of CRS compared to only 1 out of 34 (3%) in the control group (OR 6.7; 95% CI 0.84-53.10; p = 0.064). Forty-eight COPD patients (59%) and 14 controls (41%) had an abnormal SNOT-20 score (OR 1.96; 95% CI 0.87-4.40; p=0.10), with a median score of 16.0 (ICR 21) in COPD patients compared to a median score of 8.0 (ICR 13) in controls (p=0.001). The SNOT-PNS-score was abnormal in 49 COPD patients (59%) and in 9 controls (26%) (OR 4.00; 95% CI 1.66-9.64; p=0.001). Abnormal findings of the upper airways did not correlate with COPD severity or smoking status. Conclusions: CRS was a frequent diagnosis in patients with COPD. CRS reduces quality of life in this patient group.

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Sarcopenia, systemic immune-inflammation index and all-cause mortality in middle-aged and older people with chronic obstructive pulmonary disease and asthma: a population-based study

ERJ Open Research ◽

10.1183/23120541.00628-2021 ◽

2021 ◽

pp. 00628-2021

Author(s):

Elizabeth Benz ◽

Sara R.A. Wijnant ◽

Katerina Trajanoska ◽

Johnmary T. Arinze ◽

Emmely W. de Roos ◽

...

Keyword(s):

Chronic Obstructive Pulmonary Disease ◽

Older People ◽

Pulmonary Disease ◽

Mortality Risk ◽

Study Groups ◽

Population Based ◽

Chronic Obstructive ◽

Middle Aged ◽

Obstructive Pulmonary Disease ◽

All Cause Mortality

BackgroundIncreasing evidence suggests that sarcopenia and a higher systemic immune-inflammation index (SII) are linked with morbidity in patients with chronic obstructive pulmonary disease (COPD). However, whether these two conditions contribute to all-cause mortality in middle-aged and older patients with COPD or asthma is unclear. Therefore, we investigated the association between sarcopenia, SII, COPD, or asthma and all-cause mortality in a large-scale population-based setting.MethodsBetween 2009 and 2014, 4482 participants (aged>55 years, 57.3% female) from the population-based Rotterdam Study were included. COPD and asthma patients were clinically and spirometry-based diagnosed. Six study groups were defined according to the presence or absence of COPD or asthma and sarcopenia. Cox regression models were used to assess all-cause mortality in the study groups, adjusted for sex, age, BMI, SII, smoking, oral corticosteroid use and comorbidities. In addition, all participants were categorised into sex-specific quartiles of SII and mortality in these groups was compared.ResultsOver a median follow-up of 6.1 years (IQR 5.0–7.2), 466 (10.4%) persons died. Independent of the presence of sarcopenia, participants with COPD had a higher risk of all-cause mortality (HR: 2.13 [95% CI: 1.46 to 3.12], and HR: 1.70 [95% CI: 1.32 to 2.18]). Compared to lower SII levels, higher SII levels increased mortality risk even in people without sarcopenia, COPD or asthma.ConclusionMiddle-aged and older people with COPD, higher SII levels or sarcopenia had an independently increased mortality risk. Our study suggests prognostic usefulness of routinely evaluating sarcopenia and SII in older people with COPD or asthma.

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