Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, U.S.A.
IVIDATA Stats, Levallois-Perret, France.
Laryngoscope. 2019 Sep;129(9):1969-1975. doi: 10.1002/lary.27852. Epub 2019 Feb 5.
OBJECTIVES/HYPOTHESIS: Establish treatment patterns and economic burden in US patients with chronic rhinosinusitis with nasal polyposis (CRSwNP) versus without chronic rhinosinusitis (CRS). Determine comparative costs of subgroups with high clinical burden.
Observational, retrospective, case-control study.
This study matched patients with CRSwNP to patients without CRS (1:1) using the Truven Health MarketScan US claims database. Categorical and continuous variables were compared using McNemar test and paired t test (normal distribution) or Wilcoxon signed rank tests (non-normal distribution). Within subgroups, χ and Wilcoxon or t tests were used (normal distribution).
There were 10,841 patients with CRSwNP and 10,841 patients without CRS included. Mean age in the CRSwNP cohort was 45.8 years; 56.2% were male. During follow-up, patients with CRSwNP had an increased diagnosis of asthma versus patients without CRS (20.8% vs. 8.1%, respectively; P < .001). Annual incremental costs were $11,507 higher for patients with CRSwNP versus those without CRS. Costs were higher in subgroups of patients with CRSwNP undergoing functional endoscopy sinus surgery (FESS), with a comorbid diagnosis of asthma, receiving oral corticosteroids, or macrolides versus the overall CRSwNP group. Patients with CRSwNP undergoing FESS had the highest costs of the four subgroups ($26,724, $22,456, $20,695, and $20,990, respectively).
Annual incremental costs were higher among patients with CRSwNP versus without CRS. Patients with CRSwNP with high clinical burden had higher overall costs than CRSwNP patients without.
NA Laryngoscope, 129:1969-1975, 2019.
目的/假设：确定美国伴有鼻息肉的慢性鼻-鼻窦炎（CRSwNP）患者与不伴慢性鼻-鼻窦炎（CRS）患者的治疗模式和经济负担。确定具有高临床负担的亚组的比较成本。
观察性、回顾性、病例对照研究。
本研究使用 Truven Health MarketScan 美国索赔数据库，将 CRSwNP 患者与无 CRS 患者（1:1）进行匹配。使用 McNemar 检验和配对 t 检验（正态分布）或 Wilcoxon 符号秩检验（非正态分布）比较分类和连续变量。在亚组内，使用 χ 和 Wilcoxon 或 t 检验（正态分布）。
共有 10841 例 CRSwNP 患者和 10841 例无 CRS 患者纳入研究。CRSwNP 队列的平均年龄为 45.8 岁，56.2%为男性。在随访期间，CRSwNP 患者的哮喘诊断率高于无 CRS 患者（分别为 20.8%和 8.1%；P<.001）。与无 CRS 患者相比，CRSwNP 患者的年增量成本高 11507 美元。在接受功能性内镜鼻窦手术（FESS）、合并哮喘诊断、接受口服皮质类固醇或大环内酯类药物治疗的 CRSwNP 亚组患者中，成本更高。在 FESS 治疗的 CRSwNP 患者中，四个亚组中成本最高（分别为 26724 美元、22456 美元、20695 美元和 20990 美元）。
与无 CRS 患者相比，CRSwNP 患者的年增量成本更高。具有高临床负担的 CRSwNP 患者的总费用高于无 CRSwNP 患者。
NA 喉科学，129：1969-1975，2019 年。
