Objective To review the evidence whether the risk for a prolonged or chronic course increases with age in adult patients with
Data Sources PubMed, EMBASE, and the Cochrane Library.
Review Methods A comprehensive
literature search was performed on March 24, 2013, and articles were screened and selected using predefined inclusion and
exclusion criteria. Articles reporting studies on age as a predictor for the course in patients with acute rhinosinusitis
were included. For included articles, the design of reported studies was assessed for directness of evidence and risk of bias.
We aimed to extract hazard ratios for age as a continuous variable.
Results Out of 13,382 unique publications, 3
articles with moderate risk of bias were included, with a maximum follow-up period of 30 days. The reported hazard ratios
for recovery at 10, 15, and 30 days are 1.0 (95% confidence interval, 0.9-1.1) for age as a continuous variable, 0.86 (0.66-1.11)
for age dichotomized at 38 years, and 0.58 (0.40-0.84) for age dichotomized for an increase with 20 years, respectively.
and Recommendation There is no evidence that age increases the risk for chronic rhinosinusitis in adult patients with acute
rhinosinusitis. The literature is inconclusive that age increases the risk for a prolonged course of acute rhinosinusitis
and, therefore, does not provide grounds for different management according to age of patients. As such, patients can be managed
according to clinical practice guidelines with expectant observation and symptomatic treatment.