Acute sinusitis in adults in Norwegian general practice: Incidence, complications, referral to ear-nose-throat specialist and economic costs

Abstract

Objectives: To estimate the incidence of acute sinusitis among patients older than 14 years in Norwegian general practice. Furthermore, to register complications related to acute sinusitis, to assess the number of patients referred to an ENT specialist, and to estimate the costs that patients with acute sinusitis generate in the Norwegian health budget on a yearly basis.

Methods: Adult patients with the clinical diagnosis of acute sinusitis seen in primary care in the municipality of Larvik were registered during a one-year period. During the winter of 1993, computed tomography (CT) was used as a reference standard to divide the patients into two groups; with and without confirmed sinusitis. Patients referred to the ENT specialist and his conclusions as to the differential diagnosis and prognosis were registered. The yearly cost of acute sinusitis was estimated by summating the costs of consultations, referrals, medication and sick leave.

Results: During the one-year period, 1053 patients with 1138 episodes of acute sinusitis were clinically diagnosed, 69% women and 31% men. In the more detailed part of the study, 87 of the 138 patients (63%) had their clinical diagnoses confirmed by CT. The incidence of acute sinusitis was 21.7 episodes per 1000 adult inhabitants per year. 2% of the patients needed sinus puncture. Acute sinusitis generated an estimated cost of 192 million NOK per year, 75% of this was due to sick leave.

Conclusions: The yearly incidence of acute sinusitis in Norway is similar to that of other countries, such as Denmark, the Netherlands, and the United Kingdom. Two thirds of the patients with sinusitis are women. Not many of these patients are referred to an ENT specialist. The disease has few complications. Acute sinusitis generates considerable national health care expenses, sick leave being a major part.