Department of Otorhinolaryngology, Head and Neck Surgery and Audiology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
Department of Otorhinolaryngology, Head and Neck Surgery and Audiology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark; Centre for Physical Activity Research, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
Rhinology. 2021 Aug 1;59(4):374-379. doi: 10.4193/Rhin20.480.
Chronic rhinosinusitis with nasal polyps (CRSwNP) can be a challenge to treat despite appropriate pharmacological therapy and endoscopic sinus surgery. With the introduction of biological treatment, costs will increase. In this study, we determine the number of patients with CRSwNP treated with endoscopic sinus surgery and revision surgery and thereby fulfil the main criterion for treatment with biologics in the newest European guidelines. Furthermore, we estimate a potential number of recipients of biologics nationwide.
All adult patients registered in the Danish National Patient Registry as having undergone first endoscopic sinus surgery for CRSwNP from 2012â€"2018 were included. The number of operations, surgery dates, and comorbidities were extracted. The Kaplan-Meier method was used to calculate the revision rate over time. Revision surgery was used as a surrogate to determine the pool of potential recipients of biologics, as these would fulfil the eligibility criteria and ensure the necessary cost-effectiveness.
A total of 4667 operated patients with CRSwNP were included out of a population of 4.7 million adults (incidence 14/100,000 person-years). Approximately 18% (120 per year) was estimated to have revision surgery within seven years. The median time to revision surgery was 22 months. Of all analysed patients, 21% had registered asthma and/or allergic rhinitis, while these diseases were registered in 34% of patients treated with revision surgery.
In Denmark, an average of 120 operated patients annually will have revision surgery within seven years and may benefit from treatment with biologics as an alternative option to revision surgery.
尽管适当的药物治疗和内镜鼻窦手术，但慢性鼻鼻窦炎伴鼻息肉（CRSwNP）的治疗仍然具有挑战性。随着生物治疗的引入，成本将会增加。在这项研究中，我们确定了接受内镜鼻窦手术和翻修手术治疗的 CRSwNP 患者数量，从而满足了最新欧洲指南中生物治疗的主要标准。此外，我们还估计了全国范围内潜在的生物治疗接受者数量。
所有在丹麦国家患者注册中心登记的于 2012 年至 2018 年期间因 CRSwNP 接受首次内镜鼻窦手术的成年患者均被纳入研究。我们提取了手术次数、手术日期和合并症。使用 Kaplan-Meier 法计算随时间推移的翻修率。翻修手术被用作确定潜在生物治疗接受者群体的替代指标，因为这些患者符合入选标准并确保了必要的成本效益。
我们共纳入了 4667 例 CRSwNP 手术患者，他们来自 470 万成年人（发病率为 14/100,000 人年）。预计在 7 年内约有 18%（每年 120 例）的患者需要进行翻修手术。翻修手术的中位时间为 22 个月。在所有分析的患者中，21%的患者有登记哮喘和/或过敏性鼻炎，而在接受翻修手术的患者中，有 34%的患者登记了这些疾病。
在丹麦，每年平均有 120 名接受手术的患者在 7 年内需要进行翻修手术，他们可能受益于生物治疗作为翻修手术的替代选择。
