Introduction
BACKGROUND:
Chronic rhinosinusitis (CRS) is a common condition of the upper
respiratory tract(1) with poor quality of life and known associations
with the lower respiratory tract(2). It is known that socioeconomic
deprivation can be associated with a higher prevalence of asthma and
poorer lung function (3, 4). The Chronic Rhinosinusitis Epidemiology
Study (CRES) was designed to distinguish differences in socio-economic
status, geography, medical/psychiatric co-morbidity, lifestyle and
overall quality of life between patients with CRS and healthy controls.
Our previous analysis of the CRES dataset did not show evidence of any
socioeconomic disparity between CRS cases and controls(5) and this was
corroborated by a recent systematic review that found smoking was the
only key association (6). However, given the differing rates of asthma
in the two main phenotypes of CRS (2), it is possible that disparities
between these two phenotypes exist. Smoking does not appear to differ
between phenotypes both in our recent analysis and a larger dataset7,8. Other studies have considered socioeconomic
variables but have not usually compared the two main phenotypes (9, 10).
The latter review by Geramas et al10 showed an
association in some studies between CRS and low socioeconomic status but
not all studies relied on clinicians confirming the diagnosis of CRS, as
is the case in the CRES11.
Previous analyses of the CRES dataset have considered quality of life,
mood disturbances, rates of surgery and revision surgery, use of
medication, rates of allergy, asthma, aspirin sensitivity and Eustachian
tube dysfunction and the role of dietary salicylates and smoking, as
well as qualitative analyses (2, 7, 12-21). The aim of the analysis of
the CRES database presented here was to specifically compare these
variables between the two phenotypes of CRS, as this was not a feature
of our original analysis(5), and for any variables not examined in any
of the subsequent analyses that appeared worthy of closer examination.