社会人口状况和性别对囊性纤维化患者慢性鼻炎和嗅觉的影响。

IF 7.2 2区 医学 Q1 OTORHINOLARYNGOLOGY International Forum of Allergy & Rhinology Pub Date : 2024-07-05 DOI:10.1002/alr.23402
Ethan J. Han BS, Christine M. Liu BS, Jakob L. Fischer MD, Jess C. Mace MPH, CCRP, Karolin Markarian BS, Jeremiah A. Alt MD, PhD, Todd E. Bodner PhD, Naweed I. Chowdhury MD, MPH, Patricia H. Eshaghian MD, Yuqing A. Gao MD, Anne E. Getz MD, Peter H. Hwang MD, Ashoke Khanwalkar MD, Adam J. Kimple MD, PhD, Jivianne T. Lee MD, Douglas A. Li MD, Meghan Norris PA, Jayakar V. Nayak MD, PhD, Cameran Owens PA, Zara M. Patel MD, Katie Poch BS, Rodney J. Schlosser MD, Kristine A. Smith MD, Timothy L. Smith MD, MPH, Zachary M. Soler MD, MSc, Jeffrey D. Suh MD, Grant A. Turner MD, Marilene B. Wang MD, Jennifer L. Taylor-Cousar MD, MSCS, Milene T. Saavedra MD, Daniel M. Beswick MD
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引用次数: 0

摘要

背景:囊性纤维化患者(PwCF)的社会人口状况(SDS),包括种族/民族和社会经济状况,近似于教育、收入和保险状况,对肺部疾病有影响。SDS与慢性鼻炎(CRS)之间的关系仍未得到充分研究:在一项前瞻性多机构研究中,成年囊性纤维化患者完成了 22 题鼻腔结果测试 (SNOT-22)、嗅觉识别测试 (SIT)、嗅觉障碍负面陈述问卷 (QOD-NS) 和囊性纤维化问卷修订版 (CFQ-R)。此外,还收集了伦德-肯尼迪评分、鼻窦计算机断层扫描和临床数据。采用多元回归法对不同种族/民族、性别和社会经济因素的数据进行了分析:结果:73 名儿童和青少年参加了研究,平均年龄为(34.7 ± 10.9)岁,其中 49 人(67.1%)为女性。线性回归发现,使用 elexacaftor/tezacaftor/ivacaftor (ETI) (β = -4.09,95% 置信区间 [CI] [-6.08, -2.11],p 16 教育年限 (β = 13.50,95% CI [2.21, 24.80],p = 0.020) 与较高的基线预测一秒用力呼气容积百分比 (ppFEV1) 相关。医疗补助/医疗保险与较差的内镜检查评分、CFQ-R 呼吸评分和 ppFEV1 相关(均为 p 结论:在贫困家庭中,CRS 严重程度的客观测量结果与性别、年龄和 ETI 使用情况有关。在本研究中,变异状态和种族并不影响患者报告的 CRS 严重程度测量值或嗅觉。了解这些因素对治疗反应的影响可能会改善 PwCF 的护理差异:NCT04469439。
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Impact of sociodemographic status and sex on chronic rhinosinusitis and olfaction in people with cystic fibrosis

Background

Sociodemographic status (SDS) including race/ethnicity and socioeconomic status as approximated by education, income, and insurance status impact pulmonary disease in people with cystic fibrosis (PwCF). The relationship between SDS and chronic rhinosinusitis (CRS) remains understudied.

Methods

In a prospective, multi-institutional study, adult PwCF completed the 22-Question SinoNasal Outcome Test (SNOT-22), Smell Identification Test (SIT), Questionnaire of Olfactory Disorder Negative Statements (QOD-NS), and Cystic Fibrosis Questionnaire-Revised (CFQ-R). Lund–Kennedy scores, sinus computed tomography, and clinical data were collected. Data were analyzed across race/ethnicity, sex, and socioeconomic factors using multivariate regression.

Results

Seventy-three PwCF participated with a mean age of 34.7 ± 10.9 years and 49 (67.1%) were female. Linear regression identified that elexacaftor/tezacaftor/ivacaftor (ETI) use (β = ‒4.09, 95% confidence interval [CI] [‒6.08, ‒2.11], p < 0.001), female sex (β = ‒2.14, 95% CI [‒4.11, ‒0.17], p = 0.034), and increasing age (β = ‒0.14, 95% CI [‒0.22, ‒0.05], p = 0.003) were associated with lower/better endoscopy scores. Private health insurance (β = 17.76, 95% CI [5.20, 30.32], p = 0.006) and >16 educational years (β = 13.50, 95% CI [2.21, 24.80], p = 0.020) were associated with higher baseline percent predicted forced expiratory volume in one second (ppFEV1). Medicaid/Medicare insurance was associated with worse endoscopy scores, CFQ-R respiratory scores, and ppFEV1 (all p < 0.017), and Hispanic/Latino ethnicity was associated with worse SNOT-22 scores (p = 0.047), prior to adjustment for other cofactors. No other SDS factors were associated with SNOT-22, QOD-NS, or SIT scores.

Conclusions

Differences in objective measures of CRS severity exist among PwCF related to sex, age, and ETI use. Variant status and race did not influence patient-reported CRS severity measures or olfaction in this study. Understanding how these factors impact response to treatment may improve care disparities among PwCF.

Clinical Trials

NCT04469439

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来源期刊
CiteScore
11.70
自引率
10.90%
发文量
185
审稿时长
6-12 weeks
期刊介绍: International Forum of Allergy & Rhinologyis a peer-reviewed scientific journal, and the Official Journal of the American Rhinologic Society and the American Academy of Otolaryngic Allergy. International Forum of Allergy Rhinology provides a forum for clinical researchers, basic scientists, clinicians, and others to publish original research and explore controversies in the medical and surgical treatment of patients with otolaryngic allergy, rhinologic, and skull base conditions. The application of current research to the management of otolaryngic allergy, rhinologic, and skull base diseases and the need for further investigation will be highlighted.
期刊最新文献
Evaluation of mucosal barrier disruption due to Staphylococcus lugdunensis and Staphylococcus epidermidis exoproteins in patients with chronic rhinosinusitis. Guidance for the evaluation by payors of claims submitted using Current Procedural Terminology codes 95165, 95115, and 95117. Making "scents" of nutrients: Investigating the relationship between olfactory dysfunction and vitamin intake. Surgery versus biologics for nasal polyposis: Perspective on contemporary data. Issue Information
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