Department of Otolaryngology-Head and Neck Surgery, University of North Carolina, Chapel Hill, NC.
Int Forum Allergy Rhinol. 2014 Apr;4(4):272-9. doi: 10.1002/alr.21292. Epub 2014 Jan 21.
Allergic fungal rhinosinusitis (AFRS) is a refractory subtype of chronic rhinosinusitis. There is a paucity of data investigating the association of epidemiologic markers of disease severity. The primary objective of this study is to evaluate components of disease severity with socioeconomic status and health care access.
A retrospective analysis was performed on patients diagnosed with AFRS by Bent and Kuhn criteria from 2000 to 2013. Severity of disease was measured by orbitocranial involvement, bone erosion, Lund-Mackay score, serum immunoglobulin E (IgE), and mold hypersensitivity. The North Carolina State Data Center provided county-specific socioeconomic and demographic data. Fisher's exact test, Wilcoxon rank sum test, Pearson correlations, and multivariable linear regression models were used to explore associations between variables.
Of 93 patients, 58% were African American and 39% Caucasian with a male:female ratio of 1.4:1 and average age at presentation of 29 years. Race, age, insurance status, and gender were not associated with severity of disease. Bone erosion was correlated with residence in counties with lower income per capita (p = 0.01). Patients with orbitocranial involvement resided in more rural counties (p = 0.01) with less primary care providers per capita (p = 0.02). Residence in counties with older or poorer quality housing was associated with a higher prevalence of bone erosion (p = 0.02).
Within our cohort of patients residing in North Carolina, markers of disease severity (bone erosion and orbitocranial involvement) in AFRS were associated with lower income, rural counties, poor housing quality, and less health care access.
变应性真菌性鼻鼻窦炎（AFRS）是一种难治性慢性鼻鼻窦炎亚型。目前有关疾病严重程度的流行病学标志物的研究数据较少。本研究的主要目的是评估疾病严重程度与社会经济地位和医疗保健获取之间的关系。
对 2000 年至 2013 年间根据 Bent 和 Kuhn 标准诊断为 AFRS 的患者进行回顾性分析。通过眼眶颅受累、骨侵蚀、Lund-Mackay 评分、血清免疫球蛋白 E（IgE）和霉菌过敏来衡量疾病的严重程度。北卡罗来纳州数据中心提供了各县的社会经济和人口统计数据。使用 Fisher 确切检验、Wilcoxon 秩和检验、Pearson 相关分析和多变量线性回归模型来探索变量之间的关联。
在 93 名患者中，58%为非裔美国人，39%为白种人，男女比例为 1.4:1，平均发病年龄为 29 岁。种族、年龄、保险状况和性别与疾病严重程度无关。骨侵蚀与人均收入较低的县有关（p = 0.01）。眼眶颅受累的患者居住在农村县（p = 0.01），人均初级保健提供者较少（p = 0.02）。居住在住房较老旧或质量较差的县与更高的骨侵蚀发生率相关（p = 0.02）。
在我们居住在北卡罗来纳州的患者队列中，AFRS 的疾病严重程度标志物（骨侵蚀和眼眶颅受累）与低收入、农村县、较差的住房质量和较少的医疗保健获取有关。
