Konsur Evelyn, Rigg Lauren, Moore Donyea, Patel Malina, Batra Pete S, Mahdavinia Mahboobeh
Division of Allergy/Immunology, Department of Internal Medicine, Rush University Medical Center, Chicago, Illinois.
Division of Allergy/Immunology, Department of Internal Medicine, Rush University Medical Center, Chicago, Illinois.
Ann Allergy Asthma Immunol. 2022 Dec;129(6):737-741. doi: 10.1016/j.anai.2022.05.022. Epub 2022 May 24.
Chronic rhinosinusitis (CRS) is a common upper airways inflammatory disease requiring multidisciplinary care.
To evaluate if African Americans (AA), Latinxs, and nonLatinx White (White) patients have different chronic rhinosinusitis outcomes and to identify associated factors impacting these outcomes.
We conducted a large prospective cohort study of CRS patients who were evaluated and followed for several clinical variables at the initial encounter and after continuous management of CRS for a mean of 40 months. The Sinonasal Outcome Test (SNOT-22) and Lund-MacKay scores were measured on initial visits, and SNOT-22 was repeated at the end of follow-up. Logistic regression was used to compare outcomes between the different groups adjusted for comorbidities and demographics.
Among the 977 enrolled CRS cases, 615 (63.0%), 235 (24.1%) and 138 (13.0%) were White, AA and Latinx respectively. There was no difference in severity of CRS based on Lund-MacKay scores and SNOT-22 scores, and frequency of other comorbidities at presentation among the 3 groups. During the follow-up period, compared with Whites, AA and Latinx were less frequently evaluated by an allergist. AAs had less frequent CRS related visits and lower final SNOT-22 score compared with Whites.
Although our enrolled patients from the 3 ethnic groups had similar clinical characteristics and disease burden at baseline, AAs had less frequent follow-up visits and worse final SNOT-22 after 40 months of follow-up. The observed poorer outcomes in AAs are likely owing to inequity in healthcare access evidenced by differences in insurance and suboptimal management of CRS.
慢性鼻-鼻窦炎（CRS）是一种常见的上呼吸道炎性疾病，需要多学科护理。
评估非裔美国人（AA）、拉丁裔和非拉丁裔白人（白人）患者的慢性鼻-鼻窦炎结局是否不同，并确定影响这些结局的相关因素。
我们对CRS患者进行了一项大型前瞻性队列研究，在初次就诊时以及对CRS进行平均40个月的持续管理后，对患者进行了评估并跟踪了多个临床变量。在初次就诊时测量鼻窦结局测试（SNOT-22）和Lund-MacKay评分，并在随访结束时重复测量SNOT-22。使用逻辑回归比较不同组之间经合并症和人口统计学调整后的结局。
在977例登记的CRS病例中，分别有615例（63.0%）、235例（24.1%）和138例（13.0%）为白人、AA和拉丁裔。基于Lund-MacKay评分和SNOT-22评分以及三组就诊时其他合并症的频率，CRS的严重程度没有差异。在随访期间，与白人相比，过敏症专科医生对AA和拉丁裔的评估频率较低。与白人相比，AA的CRS相关就诊频率较低，最终SNOT-22评分也较低。
尽管我们纳入的来自这三个种族的患者在基线时具有相似的临床特征和疾病负担，但在随访40个月后，AA的随访就诊频率较低，最终SNOT-22评分较差。在AA中观察到的较差结局可能是由于保险差异和CRS管理欠佳所证明的医疗保健可及性不平等。
