Prevalence of Bronchiectasis in Patients with Chronic Rhinosinusitis in a Tertiary Care Center.

BACKGROUND While chronic rhinosinusitis (CRS) is associated with asthma and vice versa, the association between CRS and other lower respiratory conditions is not well established. Bronchiectasis is characterized by permanent damage of the airways, and as many as 45% of bronchiectasis patients have CRS, but the prevalence of bronchiectasis among CRS patients is not known. OBJECTIVE To determine the prevalence of bronchiectasis among CRS patients and to characterize demographic and clinical features of patients with bronchiectasis and CRS. METHODS Electronic medical records of patients with rhinosinusitis were searched by computer algorithm supplemented with manual chart review to identify patients with CRS, asthma, and/or bronchiectasis. Demographic and clinical features and antibiotic courses for sinopulmonary infections two years pre- and post- sinus surgery were obtained by manual chart review. RESULTS The prevalence of bronchiectasis as determined by the ICD-9 code was significantly higher in CRS patients than in asthmatics (2.3% vs. 1.7%; p<0.003). Similarly, based on a text-word search of "bronchiectasis" in the chest CT scan reports, patients with CRS who had chest CT scans had a higher prevalence of bronchiectasis than asthmatics with chest CT scans (24.3% vs. 19.5%; p=0.005). Patients with CRS and concurrent bronchiectasis did not have a reduction in the frequency of sinopulmonary infections following sinus surgery compared with patients with CRS without bronchiectasis (p<0.05). CONCLUSION Bronchiectasis is an important comorbidity in patients with CRS and may identify a severe phenotype of chronic sinonasal disease.