Age-Specific Risk and Severity of CRS among Cystic Fibrosis Carriers: A Population-Based Cohort Study

Abstract

Background:

Chronic rhinosinusitis (CRS) is an inflammatory disease characterized by congestion and nasal discharge, facial pain and pressure, and loss of smell, with symptoms lasting longer than 3 months. CRS is common among people with cystic fibrosis (CF) and CF carriers are also more at risk for CRS than non-CF carriers. We evaluate risk for CRS across the lifespan for CF carriers and determine how CF carriers with CRS may differ from non-CF carriers with chronic sinusitis.

Methods:

Using 2001 to 2022 MarketScan data, we developed 2 study populations: (1) a matched cohort consisting of CF carriers who were matched to non-CF carriers, and (2) a cohort of patients with chronic sinusitis. We used the matched cohorts of CF carriers and non-CF carriers to estimate age-group-specific incidence rate ratios for experiencing chronic sinusitis. Next, we used the chronic-sinusitis cohort to compare the severity of chronic sinusitis events between CF carriers and non-carriers. Specifically, we estimated the odds of a sinus procedure or the receipt of antibiotic prescriptions to evaluate the severity and healthcare utilization among CF carriers and non-carriers with CRS. Finally, we compared the odds for developing other CF-related conditions among CF carriers with CRS to non-CF carriers with CRS.

Results:

We found that CRS incidence for CF carriers relative to non-CF carriers was highest for those above 40 years of age. We also found that among people with CRS, CF carriers were more likely to undergo a diagnostic evaluation and endoscopic sinus surgery. CF carriers were also more likely to fill antibiotic prescriptions, use multiple antibiotics, and take antibiotics for longer periods.

Conclusions:

CF carriers are more likely than non-carriers to suffer from CRS, have more severe CRS, and to exhibit certain features of CF-associated CRS.