Friday, December 14, 2018

Always enquire about chronic rhinitis in asthma and COPD patients

Patients hospitalized for either asthma or chronic obstructive pulmonary disease (COPD) have a higher risk of being readmitted for a hospital stay within 30 days of release if they also suffer from chronic rhinitis, says a new research from the University of Cincinnati.

The study, published in the Journal of Allergy and Clinical Immunology: In Practice, examined 4,754 asthmatic patients and 2,176 patients with COPD for a five-year period between 2012 and 2017. The 30-day asthma- and COPD-related readmissions of patients with allergic and non-allergic rhinitis with those patients without that diagnosis were compared using multivariate hazard models adjusted for relevant patient comorbidities.

Patients with asthma and allergic rhinitis were 4.4 times more likely to be rehospitalized within 30 days of discharge compared to those patients who did not have allergic rhinitis. Asthmatics with non-allergic rhinitis were 3.7 times more likely to be re-admitted within 30 days of discharge than asthmatics without non-allergic rhinitis.

Examination of COPD patients also revealed higher probability of rehospitalization when allergic rhinitis was also present.

COPD patients with allergic rhinitis may be readmitted 2.4 times the rate within 30 days of discharges compared to COPD patients without allergic rhinitis. Similarly, COPD patients with non-allergic rhinitis were 2.6 times more likely to readmitted within 30 days of discharge vs COPD patients without non-allergic rhinitis.

This study highlights the significance of a thorough history-taking, an art which many of us might have forgotten about, perhaps to meet the rush of the day.

Whenever treating a patient of asthma or COPD, one should always enquire about comorbid chronic rhinitis – allergic or non-allergic rather than treating or managing just the asthma or COPD. And, also treat it, if present.

Sir William Osler said, “Listen to your patient, he is telling you the diagnosis.”

Dr KK Aggarwal
Padma Shri Awardee
President Elect Confederation of Medical Associations in Asia and Oceania   (CMAAO)
Group Editor-in-Chief IJCP Publications
President Heart Care Foundation of India
Immediate Past National President IMA

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