When It's Not Allergic Rhinitis: Clinical Signs to Raise a Patient's Suspicion for Chronic Rhinosinusitis.

Objective: To identify predictors of chronic rhinosinusitis (CRS) in patients presenting with the chief complaint of nasal allergies. Study Design: Cross‐sectional study. Setting: Tertiary care, academic center. Methods: Clinical and demographic characteristics were collected from participants who were patients presenting with the chief complaint of nasal allergies. From all participants, a 22‐item Sinonasal Outcome Test (SNOT‐22) was collected, and a modified Lund‐Kennedy endoscopy score was calculated from nasal endoscopy. Association was sought between having CRS and variables of clinical and demographic characteristics, SNOT‐22, and endoscopy score. Results: A total of 219 patients were recruited and 91.3% were diagnosed with allergic rhinitis; 45.2% were also diagnosed with CRS. Approximately half of the patients with CRS reported no intranasal corticosteroid usage. Having CRS was associated with male sex (odds ratio [OR] = 2.29, 95% confidence interval [CI]: 1.30‐4.04, P =.004), endoscopy score (OR = 1.96, 95% CI: 1.59‐2.42, P <.001), and the SNOT‐22 nasal subdomain score (OR = 1.07, 95% CI: 1.03‐1.11, P =.001) related to SNOT‐22 items: "need to blow nose," "thick nasal discharge," "sense of taste/smell," and "blockage/congestion of nose." At least moderate (item score ≥3) "blockage/congestion of nose" or "thick nasal discharge," mild "need to blow nose" (item score ≥2) or very mild decreased "sense of taste/smell" (item score ≥1), and any nasal endoscopy findings (endoscopy score ≥1) were statistically significant predictors of CRS. Conclusion: Moderate or more severe nasal obstruction or discharge symptoms, any decreased sense of smell/taste, or positive nasal endoscopy findings in patients believing they have allergic rhinitis should prompt further evaluation of CRS to avoid delays in treatment. [ABSTRACT FROM AUTHOR]