title: Chronic obstructive pulmonary disease predicts chronic rhinosinusitis without nasal polyps: A population-based study.
abstract: BACKGROUND
  Few studies have investigated the relationship between chronic obstructive pulmonary disease (COPD) and chronic rhinosinusitis without nasal polyps (CRSsNP) outcomes. The aim of this study was to investigate the association between COPD and the risk of CRSsNP in a large national sample.
  
  
  METHODS
  Patients 15 years or older with a new primary diagnosis of COPD (International Classification of Diseases, Ninth edition [ICD-9], 491, 492, 494, and 496) between 2000 and 2007 were identified from the National Health Insurance Research Database of Taiwan. The patients were compared with sex-, age-, residence-, and insurance premium-matched controls, and both groups were followed up until the end of 2008 for instances of CRSsNP, defined as ICD-9 codes CRS (473, 473.0, 473.1, 473.2, 473.3, 473.8, and 473.9), excluding NP (471, 471.0, 471.1, 471.8, and 471.9). Competing risk-adjusted Cox regression analyses were applied after adjusting for sex, age, residence, insurance premium, steroid use (topical or systemic), hyperlipidemia, diabetes, hypertension, coronary artery disease, hospital admission days, and mortality.
  
  
  RESULTS
  We included 34,029 cases and 34,029 matched controls in this study. Among the 68,058 subjects, 569 developed CRSsNP during a mean (standard deviation [SD]) follow-up period of 5.0 years (SD 2.2 years). COPD was an independent predictor of CRSsNP in the fully adjusted model (hazard ratio = 3.24; 95% CI = 2.65-3.96; p < 0.01).
  
  
  CONCLUSIONS
  COPD was associated with an increased risk of CRSsNP in this study population, independent of a number of potential confounding factors.
authors.affiliation: Department of Otorhinolaryngology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
authors.forename: Chen-Yu
authors.initials: CY
authors.lastname: Chien
authors.forename: Shu-Yu
authors.initials: SY
authors.lastname: Tai
authors.forename: Ling-Feng
authors.initials: LF
authors.lastname: Wang
authors.forename: Charles Tzu-Chi
authors.initials: CT
authors.lastname: Lee
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002908:Chronic Disease; D015986:Confounding Factors, Epidemiologic; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D029424:Pulmonary Disease, Chronic Obstructive / Q000453:epidemiology*; D012044:Regression Analysis; D012220:Rhinitis / Q000453:epidemiology*; D012852:Sinusitis / Q000453:epidemiology*; D013624:Taiwan / Q000453:epidemiology; D055815:Young Adult