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- Title
Increased risk of cholesteatoma among patients with allergic rhinitis: A nationwide investigation.
- Authors
Kuo, Chin‐Lung; Shiao, An‐Suey; Wen, Hsyien‐Chia; Chang, Wei‐Pin; Kuo, Chin-Lung; Shiao, An-Suey; Wen, Hsyien-Chia; Chang, Wei-Pin
- Abstract
<bold>Objectives: </bold>No large population-based studies have reported on the risk of cholesteatoma developing after allergic rhinitis (AR). This study used a nationwide population-based claims database to investigate the hypothesis that AR may increase the risk of cholesteatoma.<bold>Study Design: </bold>Retrospective cohort study.<bold>Methods: </bold>Data from Taiwan's Longitudinal Health Insurance Database were analyzed to compile the following: 1) 15,953 patients newly diagnosed with AR between 1997 and 2000, and 2) a comparison cohort of 63,812 matched non-AR enrollees (with a ratio of 1 to 4). Each patient was followed for 10 years to identify cases in which cholesteatoma subsequently developed. The Kaplan-Meier method was used to determine the cholesteatoma-free survival rate, and the log-rank test was used to compare survival curves. Cox proportional hazard regressions were performed to compute adjusted hazard ratios (HRs).<bold>Results: </bold>Among the 79,765 patients enrolled in this study, 45 (159,364 person-years) from the AR cohort and 88 (638,130 person-years) from the comparison cohort were diagnosed with cholesteatoma during the follow-up period (incidence rates 0.28 and 0.14 of 1,000 person-years, respectively). Patients with AR were more likely to develop cholesteatoma compared to those without AR (adjusted HR 1.57, 95% confidence interval = 1.05-2.34, P < 0.05). Patients with AR presented a significantly lower 10-year cholesteatoma-free survival rate than did those in the comparison group (log-rank, P < 0.001).<bold>Conclusion: </bold>This is the first study to demonstrate a link between AR and the development of cholesteatoma. We suggest that clinicians keep this association in mind and carefully investigate the possibility of development of cholesteatoma among patients with AR.<bold>Level Of Evidence: </bold>3b. Laryngoscope, 128:547-553, 2018.
- Subjects
ALLERGIC rhinitis; CHOLESTEATOMA; PROGRESSION-free survival; MIDDLE ear diseases; DISEASE incidence; PATIENTS; DISEASE risk factors; CONFIDENCE intervals; LONGITUDINAL method; REGRESSION analysis; RHINITIS; SURVIVAL; PROPORTIONAL hazards models; RETROSPECTIVE studies; DESCRIPTIVE statistics; KAPLAN-Meier estimator; LOG-rank test; DISEASE complications
- Publication
Laryngoscope, 2018, Vol 128, Issue 3, p547
- ISSN
0023-852X
- Publication type
journal article
- DOI
10.1002/lary.26220