Zhao Qiuliang, Yu Li, Jin Peng, Ma Wen, Duan Shuonan, Luo Hang
Department of Otolaryngology, Jinan Central Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China.
Department of Otolaryngology, Central Hospital Affiliated to Shandong First Medical University, Jinan, China.
Ann Transl Med. 2022 Feb;10(3):150. doi: 10.21037/atm-22-65.
Chronic rhinosinusitis with nasal polyposis (CRSwNP) is a frequently diagnosed chronic disease that has been widely recognized as a significant economic strain on society. Recently, concern about the rising prevalence of eosinophilia in CRSwNP has attracted research interest. A comprehensive understanding of the characteristics and disease burden of CRSwNP patients may contribute to improved management of these patients.
We conducted a multi-center retrospective observational study based on real-world data. Patients were filtered into three groups: CRSwNP overall group, CRSwNP surgical group, and CRSwNP patients who had a relapse after surgeries. Furthermore, we used laboratory test results of blood eosinophil percentage (EOS%) as an indicator of eosinophilia. The comorbidities and medications of patients in the high and low EOS% groups were compared. Disease burden was measured from two aspects: direct costs and loss of working days.
A total of 1,724 CRSwNP patients were eligible, 527 of which were filtered into the surgical groups. Only 16 patients in this study were found to have a relapse. The mean ages of the CRSwNP non-surgical, CRSwNP surgical, and CRSwNP relapse groups were 46, 47, and 52.5 years old, respectively. Most patients sought treatment in the otolaryngology department. Among all three groups, the most prevalent comorbidities were allergic rhinitis and asthma. The most prescribed drug was intranasal/oral corticosteroids. The direct costs per person/year for the non-surgical group, surgical group, and relapse group were ¥188.60, ¥15,190.00, and ¥14,160.00, respectively. The loss of working days per person/year for the non-surgical group, surgical group, and relapse group was 10.41, 24.40, and 21.65 days, respectively.
CRSwNP is a disease of middle age. It is frequently associated with asthma and allergic rhinitis. Eosinophilia was found to have a considerate influence on patients' treatment patterns. Based on available data, we noted that patients in the high EOS% group were more likely to have asthma and allergic rhinitis. Intranasal/oral corticosteroids were the most frequently used drug for patients with CRSwNP, while a smaller proportion of patients in the high EOS% group used intranasal/oral corticosteroids. The disease burden of CRSwNP is posing significant challenges to both patients and society.
慢性鼻窦炎伴鼻息肉（CRSwNP）是一种常被诊断出的慢性疾病，已被广泛认为是对社会的重大经济负担。最近，对CRSwNP中嗜酸性粒细胞增多症患病率上升的关注引起了研究兴趣。全面了解CRSwNP患者的特征和疾病负担可能有助于改善对这些患者的管理。
我们基于真实世界数据进行了一项多中心回顾性观察研究。患者被分为三组：CRSwNP总体组、CRSwNP手术组和手术后复发的CRSwNP患者组。此外，我们将血液嗜酸性粒细胞百分比（EOS%）的实验室检测结果用作嗜酸性粒细胞增多症的指标。比较了高EOS%组和低EOS%组患者的合并症和用药情况。从直接成本和工作日损失两个方面衡量疾病负担。
共有1724例CRSwNP患者符合条件，其中527例被纳入手术组。本研究中仅发现16例患者复发。CRSwNP非手术组、CRSwNP手术组和CRSwNP复发组的平均年龄分别为46岁、47岁和52.5岁。大多数患者在耳鼻喉科就诊。在所有三组中，最常见的合并症是过敏性鼻炎和哮喘。最常开具的药物是鼻用/口服糖皮质激素。非手术组、手术组和复发组每人每年的直接成本分别为188.60元、15190.00元和14160.00元。非手术组、手术组和复发组每人每年的工作日损失分别为10.41天、24.40天和21.65天。
CRSwNP是一种中年疾病。它常与哮喘和过敏性鼻炎相关。发现嗜酸性粒细胞增多症对患者的治疗模式有相当大的影响。基于现有数据，我们注意到高EOS%组的患者更有可能患有哮喘和过敏性鼻炎。鼻用/口服糖皮质激素是CRSwNP患者最常用的药物，而高EOS%组中使用鼻用/口服糖皮质激素的患者比例较小。CRSwNP的疾病负担给患者和社会都带来了重大挑战。
