title: Nasal and sinus symptoms and chronic rhinosinusitis in a population-based sample.
abstract: BACKGROUND
  The objective of this study was to describe the first US-based study to use the European Position Paper on Rhinosinusitis (EPOS) criteria to study the prevalence of chronic rhinosinusitis (CRS) in a general-population sample.
  
  
  METHODS
  A CRS symptom questionnaire was mailed to 23 700 primary care patients from Geisinger Clinic, a health system serving 45 counties in Pennsylvania. CRS cases were categorized into four unique subgroups based on EPOS symptoms: obstruction and discharge with no smell loss or pain/pressure; smell loss without pain/pressure; facial pain and/or pressure without smell loss; and both smell loss and pain/pressure. All cases were required to have nasal obstruction or discharge. Logistic regression was used to evaluate potential factors associated with CRS subgroups.
  
  
  RESULTS
  We found that 11.9% of patients met criteria for CRS. Prevalence peaked at 15.9% between ages 50 and 59 years and then dropped to 6.8% after age 69. The odds of CRS was higher among patients who were white, younger, smokers, had a history of Medical Assistance, and had other diseases. When CRS subgroups were modeled separately, these associations were no longer significant for some CRS subgroups. Comorbid diseases were most strongly associated with CRS cases who reported smell loss and facial pain and/or pressure and had the weakest associations with CRS cases who did not report these symptoms.
  
  
  CONCLUSIONS
  CRS is a highly prevalent and heterogeneous condition. Differences in risk factors and health outcomes across symptom subgroups may be indicative of differences in etiology that have implications for disease management.
authors: Department of Epidemiology and Health Services Research, Geisinger Health System, Danville, PA, USA.
authors: A G
authors: AG
authors: Hirsch
authors: Research Development and Dissemination, Sutter Health, San Francisco, CA, USA.
authors: W F
authors: WF
authors: Stewart
authors: Department of Epidemiology and Health Services Research, Geisinger Health System, Danville, PA, USA.
authors: A S
authors: AS
authors: Sundaresan
authors: Department of Biomedical and Translational Informatics, Geisinger Health System, Danville, PA, USA.
authors: A J
authors: AJ
authors: Young
authors: Department of Otolaryngology/Head and Neck/Facial Plastic Surgery, Geisinger Health System, Danville, PA, USA.
authors: T L
authors: TL
authors: Kennedy
authors: Department of Otolaryngology/Head and Neck/Facial Plastic Surgery, Geisinger Health System, Danville, PA, USA.
authors: J
authors: J
authors: Scott Greene
authors: Department of Biomedical and Translational Informatics, Geisinger Health System, Danville, PA, USA.
authors: W
authors: W
authors: Feng
authors: Department of Otolaryngology Head and Neck Surgery Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.|Division of Allergy and Immunology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
authors: B K
authors: BK
authors: Tan
authors: Department of Otolaryngology Head and Neck Surgery Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.|Division of Allergy and Immunology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
authors: R P
authors: RP
authors: Schleimer
authors: Department of Otolaryngology Head and Neck Surgery Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.|Division of Allergy and Immunology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
authors: R C
authors: RC
authors: Kern
authors: University of Rochester School of Medicine and Dentistry, University of Rochester Medical Center, Rochester, NY, USA.
authors: A
authors: A
authors: Lidder
authors: Department of Epidemiology and Health Services Research, Geisinger Health System, Danville, PA, USA.|Department of Environmental Health Sciences, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MA, USA.
authors: B S
authors: BS
authors: Schwartz
mesh_terms: D000328:Adult; D000368:Aged; D002908:Chronic Disease; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010414:Pennsylvania / Q000453:epidemiology; D010641:Phenotype; D011159:Population Surveillance; D015995:Prevalence; D012220:Rhinitis / Q000175:diagnosis* / Q000453:epidemiology*; D012852:Sinusitis / Q000175:diagnosis* / Q000453:epidemiology*; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D063189:Symptom Assessment
keywords: chronic rhinosinusitis; epidemiology