References Introduc0on: There exists a strong associa?on between chronic rhinosinusi?s (CRS) disease burden and pulmonary status in asthma?c CRS pa?ents. Objec0ve: To determine the associa?on between acute exacerba?ons of CRS (AECRS) and asthma exacerba?ons of varying severity. Material and Methods: For this cross-sec?onal study 105 asthma?c pa?ents with CRS were prospec?vely recruited. CRS burden was measured using the 22-item Sinonasal Outcome Test , and metrics of AECRS including

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... ted sinus infec?ons and CRS-related an?bio?c usage over the preceding year. Asthma exacerba?on frequency was measured using frequency of asthma-related oral cor?costeroids and asthma-related emergency department (ED) visits over the prior year. Results: The frequency of asthma-related oral cor?costeroids used was associated with the frequency of pa?ent-reported sinus infec?ons (adjusted rela?ve risk [RR]=1.23, 95%CI: 1.06-1.43, p=0.007), and CRS-related an?bio?cs usage (adjusted RR=1.20, 95%CI: 1.02-1.43, p=0.031) but not associated with SNOT-22 score (p>0.050). The frequency of asthma-related ED visits was not associated with any metric of CRS burden. Abstract • Prospec?ve cross-sec?onal study with 105 pa?ents with CRS • CRS burden: measured using the 22-item Sinonasal Outcome Test (SNOT-22) • Metrics of AECRS: pa?ent-reported sinus infec?ons and CRS-related an?bio?c usage over the preceding year • Asthma exacerba?on frequency: measured using frequency of asthma-related oral cor?costeroids and asthma-related emergency department visits over prior year • Associa?on between CRS disease burden and asthma exacerba?ons largely driven by AECRS • This associa?on did not carry over to asthma-related ED usage, perhaps due to low frequency of ED usage • Possible reflec?on of mul?faceted-and oaen-socioeconomic-u?liza?on pacerns of ED usage Discussion • Chronic rhinosinusi?s (CRS) a common inflammatory disease of the paranasal sinus mucosa that results in loss of produc?vity and quality of life detriment • CRS disease consequences driven by CRS disease manifesta?ons: chronic symptomatology, acute exacerba?ons of CRS (AECRS), exacerba?on of pulmonary disease • AECRS may be important drivers of asthma exacerba0ons • Hypothesis: AECRS frequency is associated with metrics of asthma exacerba0ons: asthma-related oral cor0costeroids and asthma-related emergency department (ED) visits Results • Figure 1A : Scacerplot of asthma-related oral cor?costeroids courses vs. sinus infec?ons in the last year. • Figure 1B : Scacerplot of asthma-related oral cor?costeroids vs. CRS-related an?bio?cs in the last year. Material and Methods Introduc0on The frequency of asthma-related oral cor?costeroids used was associated with the frequency of pa?entreported sinus infec?ons (adjusted rela?ve risk [RR]=1.23, 95%CI: 1.06-1.43, p=0.007), and CRS-related an?bio?cs usage (adjusted RR=1.20, 95%CI: 1.02-1.43, p=0.031) but not associated with SNOT-22 score (p>0.050). The frequency of asthma-related ED visits was not associated with any metric of CRS burden. 0 2 4 6 8 0 2 4 6 0 2 4 6 8 Asthma-related oral corticosteroids courses CRS-related antibiotics Sinus infections In the last year: A) B) 0 2 4 6 8 0 1 2 3 0 2 4 6 8 Asthma-related ED visits CRS-related antibiotics Sinus infections In the last year: A) B) • Figure 2A : Scacerplot of asthma-related ED visits in the last year vs. sinus infec?ons in the last year. • Figure 2B : Scacerplot of asthma-related ED visits in the last year vs. CRS-related an?bio?cs in the last year.