Table 3 Clinical risk factors for acute exacerbations in CRS
Author/year | Study design | Study participants | Definition of an acute exacerbation | Clinical risk factors | Results | Level of evidence |
|---|---|---|---|---|---|---|
Rank, et al. (2010) [9] | Retrospective cohort study | CRS exacerbation | Systemic antibiotics, systemic corticosteroid, plans for a semi-urgent surgical intervention, emergency department or urgent care visit, or a hospitalization for CRS. | Winter months | Twice as likely to present for a CRS exacerbation in winter months compared with spring, summer, or fall. | 4 |
Banoub, et al. (2018) [11] | Prospective | Asthmatic CRS | Sinus infections, CRS-related antibiotics use, CRS-related oral corticosteroids use. | Lower ACT scores (Poor asthma control). | AE are negatively associated with the level of asthma control in asthmatic CRS patients, independent of CRS symptom severity. | 4 |
Kuiper, et al. (2018) [15] | Prospective | Acute exacerbations of NSS in patients with CRS | 1.Self-reported medication use (antibiotics and oral corticosteroids) for worsened NSS; 2. duration (≥ 1 week) of worsened aggregate NSS; 3. duration (≥ 1 week) of worsened aggregate NSS and self-reported worsened purulence in the past 4 weeks. | Current long-term CRS status, high body mass index, asthma, hay fever, sinus surgery history, and winter season. | CRS status (current long-term, current recent, past, never), body mass index, asthma, hay fever, sinus surgery history, and winter season consistently predicted acute exacerbations of NSS. | 4 |
Ikeda, et al. (2011) [21] | Prospective | CRSwNP with asthma undergoing ESS | Acute exacerbation of CRS defined by the presence of purulent sinonasal secretions in conjunction with sinus-related symptoms. | Bacterial infection | Positive culture was obtained in 10 out of 11 patients. | 4 |
Kwah, et al. (2020) [22] | Retrospective cohort study | frequent exacerbations of CRS | worsening sinus symptoms and CRS-related antibiotics usage | Asthma, allergic rhinitis, eosinophil count ≥150/μL, and autoimmune disease | Frequent AECRS was characterized by a higher prevalence of asthma, allergic rhinitis, eosinophil count ≥150/μL, autoimmune disease. | 4 |
Phillips, et al. (2018) [23] | Prospective | CRS exacerbation | CRS-related antibiotics usage, sinus infections. | High SNOT-22 scores. | SNOT-22 score is associated with the number of antibiotics which were highly correlated with the number of reported sinus infections. | 4 |