Department of Otolaryngology-Head and Neck Surgery, University of California, Irvine, Orange, CA.
Int Forum Allergy Rhinol. 2015 Apr;5(4):318-25. doi: 10.1002/alr.21473. Epub 2014 Dec 26.
We sought to examine the trends in rates and demographics of ambulatory endoscopic and open sinus surgery for chronic sinusitis over a 7-year period in the state of California.
Patient records with Current Procedural Terminology (CPT) codes for endoscopic or open sinus surgery, and diagnosis codes for chronic rhinosinusitis were extracted from the California Ambulatory Surgery Datasets from 2005 to 2011. Population-adjusted surgery rates were calculated as the number of surgeries per 100,000 California residents. Location of surgery was analyzed in 2 contexts: freestanding ambulatory surgery centers (ASCs) vs any hospital setting, and academic (university medical centers) vs nonacademic centers (ASCs and non-university hospitals combined). Patients' demographics were also examined.
A total of 91,984 sinus surgeries were performed during 2005 to 2011. The overall population-adjusted surgery rate declined 24%, from 38.9 to 29.6 (p = 0.004). Although the rates for both endoscopic and open surgeries declined, the percentage of endoscopic procedures increased from 87.3% to 92.5% of all surgeries (p = 0.002). Over the studied period, there was an increase in the proportion of sinus surgeries performed in hospitals (73.2% to 91.3%; p = 0.01), in academic centers (5.9% to 10.1%; p = <0.001), on patients >65 years (14.7% to 17.8%; p = 0.003), and on non-Caucasians (10.3% to 16.9%; p < 0.001). Gender distribution remained unchanged (51% male; p = 0.25).
The overall rate of ambulatory sinus surgery in California declined over the study period. A shift from open to endoscopic procedures, from ASCs to hospitals, and from nonacademic to academic centers was observed. Further investigation of the observed trends may be warranted.
我们旨在研究在加利福尼亚州的 7 年内，门诊内镜鼻窦手术和开放式鼻窦手术治疗慢性鼻窦炎的趋势及其相关人口统计学特征。
从 2005 年至 2011 年，我们从加利福尼亚州门诊手术数据集提取了使用当前操作术语 (CPT) 代码进行内镜或开放式鼻窦手术以及诊断为慢性鼻-鼻窦炎的患者记录。将手术率调整为每 10 万加利福尼亚居民的手术数量。手术地点分别在以下两种情况下进行了分析：独立的门诊手术中心 (ASC) 与任何医院环境，以及学术（大学医疗中心）与非学术中心（ASC 和非大学医院的组合）。还检查了患者的人口统计学特征。
在 2005 年至 2011 年期间共进行了 91984 例鼻窦手术。总体人口调整后的手术率下降了 24%，从 38.9 降至 29.6（p=0.004）。尽管内镜和开放式手术的比率均下降，但内镜手术的比例从所有手术的 87.3%增加到 92.5%（p=0.002）。在研究期间，在医院进行鼻窦手术的比例有所增加（从 73.2%增加到 91.3%；p=0.01），在学术中心进行手术的比例有所增加（从 5.9%增加到 10.1%；p<0.001），在年龄超过 65 岁的患者中进行手术的比例有所增加（从 14.7%增加到 17.8%；p=0.003），在非白种人患者中进行手术的比例有所增加（从 10.3%增加到 16.9%；p<0.001）。性别分布保持不变（51%为男性；p=0.25）。
在研究期间，加利福尼亚州门诊鼻窦手术的总体比率有所下降。我们观察到从开放式手术向内镜手术，从 ASC 向医院，从非学术中心向学术中心的转变。可能需要进一步调查观察到的趋势。
