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Real-World Database Examining the Association between Sjögren's Syndrome and Chronic Rhinosinusitis
Geng-He Chang1, Yu-Cheng Chen2, Ko-Ming Lin3,4
1Department of Otolaryngology ⁻ Head and Neck Surgery, Chiayi Chang Gung Memorial Hospital, Chiayi 613, Taiwan. genghechang@gmail.com.
Objective:
To investigate the risk of chronic rhinosinusitis (CRS) among patients with Sjögren's syndrome (SS).
Method:
A total of 18,723 patients diagnosed with SS between 1997 and 2011 were retrospectively analyzed. Moreover, 59,568 patients without SS were matched to patients with SS at a 1:4 ratio on the basis of sex, age, urbanization level, income level, and the comorbidities of rhinitis and nasal sepal deviation. Patients were followed up until death or the end of the study period (31 December, 2013). The primary outcome was the occurrence of CRS.
Results:
The cumulative incidence of CRS was significantly higher in patients with SS than in those without SS (p < 0.001). The adjusted Cox proportional hazard model showed that patients with SS had a significantly higher incidence of CRS (hazard ratio, 2.51; 95% confidence interval, 2.22⁻2.84; p < 0.001). Sensitivity and subgroup analyses demonstrated SS was an independent risk factor for CRS. The dosage of intranasal corticosteroid spray used was not different between the SS and non-SS groups. Fewer patients with CRS in the SS group underwent sinus surgery (82/407 (20.2%)) than those in the non-SS group (179/667 (26.8%)) and this finding was statistically significant (p = 0.013). The number of operations did not differ significantly between patients with CRS in the SS and non-SS groups.
Conclusions:
SS is an independent risk factor for CRS. Our study extends the disease spectrum and prompts physicians to be aware of potential CRS occurrence after SS.