Rhinosinusitis in morbidity registrations in Dutch General Practice: a retro-spective case-control study.

BACKGROUND: There is only limited accurate data on the epidemiology of rhinosinusitis in primary care. This study was conducted to assess the incidence of acute and chronic rhinosinusitis by analysing data from two Dutch general practice registration projects. Several patient characteristics and diseases are related to the diagnosis rhinosinusitis. METHODS: The Continuous Morbidity Registration (CMR) and the Transitionproject (TP) are used to analyse the data on rhinosinusitis in primary practice. Both registries use codes to register diagnoses. RESULTS: In the CMR 3244 patients are registered with rhinosinusitis and in the TP 5424 CMR: The absolute incidence of (acute) rhinosinusitis is 5191 (18.8 per 1000 patient years). Regarding an odds ratio of 5.58, having nasal polyps is strongest related to rhinosinusitis compared to the other evaluated comorbidities. A separate code for chronic rhinosinusitis exists, but is not in use. TP: Acute and chronic rhinosinusitis are coded as one diagnosis. The incidence of rhinosinusitis is 5574 or 28.7 per 1000 patient years. Patients who visit their general practitioner with "symptoms/complaints of sinus", allergic rhinitis and "other diseases of the respiratory system" have the highest chances to be diagnosed with rhinosinusitis. Medication is prescribed in 90.6 % of the cases. CONCLUSIONS: Rhinosinusitis is a common diagnosis in primary practice. In the used registries no difference could be made between acute and chronic rhinosinusitis, but they give insight in comorbidity and interventions taken by the GP in case of rhinosinusitis.

No COVID-19 in Patients With Sudden Sensorineural Hearing Loss (SSNHL).

BACKGROUND: Various case reports have described sudden sensorineural hearing loss (SSNHL) in patients with the 2019 novel coronavirus disease (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Our aim was to determine the incidence of COVID-19 in patients with SSNHL. METHODS: All consecutive patients with audiometric confirmed SSNHL between November 2020 and March 2021 in a Dutch large inner city teaching hospital were included. All patients were tested for COVID-19 by polymerase-chain-reaction (PCR) and awaited the results in quarantine. RESULTS: Out of 25 patients, zero (0%) tested positive for COVID-19. Two patients had previously tested positive for COVID-19: at three and eight months prior to the onset of hearing loss. CONCLUSIONS: This is the largest series to date investigating COVID-19 in SSNHL patients. In this series there is no apparent relationship between SSNHL and COVID-19.

Management of rhinosinusitis in Dutch general practice.

AIMS: To determine whether general practitioners (GPs) distinguish between the management of acute rhinosinusitis (ARS) and chronic rhinosinusitis (CRS), especially with regard to prescription of antibiotics and nasal steroids. METHODS: A questionnaire on the management of rhinosinusitis was sent to 1000 GPs in The Netherlands. RESULTS: Ninety-six percent discriminated between ARS and CRS. However, the definition of ARS and CRS varied. The percentage of GPs prescribing antibiotics rose as rhinosinusitis severity increased. The prescription rate of nasal corticosteroids was highest for CRS (88.6%). Prescribing nasal corticosteroids in ARS was not very common. CONCLUSIONS: Most GPs discriminate between ARS and CRS and 54% accepted (the EP3OS-defined) 12 weeks as the division between ARS and CRS. Antibiotics and nasal steroids are commonly used agents, but the management of rhinosinusitis is not always consistent with guidelines.

Acute and chronic rhinosinusitis and allergic rhinitis in relation to comorbidity, ethnicity and environment.

BACKGROUND: This study was conducted to assess the effect of comorbidity, ethnicity, occupation, smoking and place of residence on allergic rhinitis (AR), acute rhinosinusitis (ARS) and chronic rhinosinusitis (CRS). METHODS: A GA2LEN (The Global Allergy and Asthma European Network) screening questionnaire was sent to a random sample of the Dutch population (n = 16700) in three different areas of the Netherlands. RESULTS: Fifty percent (8347) of the questionnaires sent were returned. A total of 29% respondents (27-31% in different areas) met the criteria for AR, 18% (17-21%) for ARS and 16% (13-18%) for CRS. Risk factors for AR were itchy rash, eczema, adverse response after taking a painkiller, asthma, CRS and ARS. Moreover, the risk of AR was twice as low for full-time housewives/househusbands than for people with jobs. The risk of ARS or CRS was significantly higher in respondents with a doctor's diagnosis of CRS, AR, itchy rash or smoking. The risk of CRS was also significantly higher in respondents with an adverse response after taking painkillers, active smoking or asthma. Caucasians are generally less likely to have AR or CRS than Latin-Americans, Hindustani and African-Creoles, and more likely to have ARS than Asian, Hindustani, Mediterranean and African-Creoles. CONCLUSIONS: This study found shared and distinct risk factors for AR, ARS and CRS and therefore provides support for the belief that they have shared symptoms but are different diseases with different aetiologies.

Adverse patient occurrences in otorhinolaryngology: results of a systematic registry in a tertiary referral hospital.

OBJECTIVE: To identify patient groups at risk for Adverse Patient Occurrences (APOs) to improve the quality of care. STUDY DESIGN: This study was conducted using retrospective analysis. METHODS: APOs have been systematically registered from 1997 to 2006 in all patients (6,932) admitted to the otorhinolaryngology-head and neck surgery department of the University Hospital Maastricht, the Netherlands. Several characteristics such as length of stay, age, gender, season, and diagnosis were related to the incidence and type of APOs. RESULTS: Increasing age and length of stay are related to an increasing incidence of APOs. Children are found to be at high risk too and outpatient treatment (<24 h) is a risk factor for APOs. Of all APOs, 67% were organizational and 33% medical. The three diagnosis-related groups (DRGs), in which APOs occurred most, were the inner ear/cerebellopontine angle (CPA), esophagus, and head and neck oncology group. No seasonal influences on APO occurrences existed. CONCLUSIONS: Male and female patients >60 or <10 years old are at the highest risk for APOs. Their risk increases with their length of stay and is high when admitted less than 24 hours. When patients are among the three most prevalent DRGs, their risk is even higher.