Co-occurrence of bronchiectasis among patients with chronic rhinosinusitis based on associated asthma.

BACKGROUND

The exact interaction, if any, among chronic rhinosinusitis (CRS) subtypes (with [CRSwNP] and without [CRSsNP] nasal polyps), asthma, and bronchiectasis is not well understood.

OBJECTIVE

To investigate the prevalence of bronchiectasis and associated factors across CRS phenotypes stratified by asthma status.

METHODS

Chart review was performed on 395 patients with CRS who underwent high-resolution chest computed tomography between January 8, 2018 and April 25, 2024 at Montefiore Medical Center. Patients were categorized into those with CRSwNP and CRSsNP, with and without asthma (n = 79 for each group). Controls consisted of patients with asthma but without CRS. Binary logistic regression was used to determine the odds ratio (OR) of having bronchiectasis in the studied groups.

RESULTS

Overall, patients with CRSsNP had lower rates and odds of having bronchiectasis than those with CRSwNP (15.2% vs 21.5%, OR = 0.123, 95% CI: 0.01-0.81). Among patients with CRSwNP, those with asthma were more likely to have bronchiectasis (26.6% vs 16.5%, OR = 8.76, 95% CI: 1.07-71.65, P = .04). Conversely, among patients with CRSsNP, the presence of asthma did not influence the rates and odds of bronchiectasis (13.9% vs 16.5%, OR = 1.33, 95% CI: 0.47-3.73). We observed a lower number of patients with an eosinophil count greater than or equal to 150 cells/µL among those with CRSwNP and bronchiectasis compared with CRSwNP without bronchiectasis (50% vs 66.9%, P = .03). Older age was associated with higher odds of bronchiectasis in all groups.

CONCLUSION

The odds and prevalence of bronchiectasis differ on the basis of the CRS phenotype: they are higher in patients with CRSwNP than in those with CRSsNP, and in patients with CRSwNP and asthma compared with those with CRSwNP without asthma. Different rates of eosinophilia might suggest different inflammatory mechanisms with potential treatment implications for overlapping airway diseases.