Firas Hentati, Jaehee Kim, David Hoying, Brian D'Anza, Kenneth Rodriguez
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引用次数: 1
Abstract
Objective: The purpose of this study is to characterize the presentation, outcomes, and barriers to care for White and non-White patients undergoing endoscopic sinus surgery (ESS).
Background: ESS is often successful in providing long-term relief for patients suffering from chronic rhinosinusitis (CRS). Literature that uses robust measures of socioeconomic status (SES) and barriers to care to assess ESS outcomes is limited.
Methods: A retrospective matched cohort study of patients who underwent ESS for CRS between 1/1/2015 and 6/1/2021 at a single tertiary care academic center was conducted. White and non-White patients were matched 1-to-1 by sex and age (± 5 years). SES was evaluated using the area of deprivation index (ADI).
Results: Of the 298 patients included in the study, 149 are White and 149 are non-White, 111 (37.2%) have CRS with nasal polyposis (CRSwNP), 141 (47.3%) had allergic rhinitis, 90 (30.2%) had asthma and 22 (7.4%) required revision ESS. Non-White patients were 3.62 times more likely to present with CRSwNP (95% confidence interval [CI] 2.2-5.96) and had 2.87 times increased odds for requiring revision ESS than age and sex-matched White patients (95% CI 1.090-7.545). The median ADI for non-White (6.00) patients was higher than for White patients (3.00) (P < .001) and 21.5% more non-White patients presented with Medicaid (P < .001).
Conclusion: Non-White patients undergoing ESS for CRS are more likely to present from areas with fewer resources and be underinsured. Using robust measures of SES, such as ADI, may allow for care to be tailored to patients with barriers to care.
目的:本研究的目的是描述接受内窥镜鼻窦手术(ESS)的白人和非白人患者的表现、结果和护理障碍。背景:ESS通常能成功地为慢性鼻窦炎(CRS)患者提供长期缓解。使用社会经济地位(SES)和护理障碍的有力衡量标准来评估ESS结果的文献有限。方法:对2015年1月1日至2021年6月1日在一家三级医疗学术中心接受CRS ESS的患者进行回顾性配对队列研究。白人和非白人患者按性别和年龄(±5岁)1:1匹配。使用剥夺面积指数(ADI)评估SES。结果:在纳入研究的298名患者中,149名为白人,149名非白人,111名(37.2%)患有CRS伴鼻息肉病(CRSwNP),141名(47.3%)患有过敏性鼻炎,90名(30.2%)患有哮喘,22名(7.4%)需要翻修ESS。非白人患者出现CRSwNP的可能性是年龄和性别匹配的白人患者的3.62倍(95%置信区间[CI]2.2-5.96),需要翻修ESS的几率是白人患者的2.87倍(95%可信区间1.090-7.545)。非白人患者的中位ADI(6.00)高于白人患者(3.00)(P P 结论:接受CRS ESS的非白人患者更有可能来自资源较少的地区,并且保险不足。使用强有力的SES指标,如ADI,可以为有护理障碍的患者量身定制护理。
期刊介绍:
The American Journal of Rhinology & Allergy is a peer-reviewed, scientific publication committed to expanding knowledge and publishing the best clinical and basic research within the fields of Rhinology & Allergy. Its focus is to publish information which contributes to improved quality of care for patients with nasal and sinus disorders. Its primary readership consists of otolaryngologists, allergists, and plastic surgeons. Published material includes peer-reviewed original research, clinical trials, and review articles.