Gill Amarbir S, Meeks Huong, Curtin Karen, Alt Jeremiah A
Division of Otolaryngology - Head and Neck Surgery, Department of Surgery, University of Utah, Salt Lake City, Utah.
Pedigree and Population Resource, 20270Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah.
Am J Rhinol Allergy. 2022 Nov;36(6):727-732. doi: 10.1177/19458924221105926. Epub 2022 Jun 13.
Large epidemiologic studies have suggested that a history of tobacco use may be associated with an increased risk of developing chronic rhinosinusitis (CRS). The impact of tobacco use on revision rates of endoscopic sinus surgery (ESS), however, remains limited.
This study seeks to define the independent risk of tobacco use (active or prior) on revision rates of ESS among a large cohort of patients with CRS.
A state population database was queried for patients age ≥18 years with CRS who underwent at least one ESS between 1996 and 2018. Demographic characteristics, history of ESS, and tobacco use status were compared across patients with CRS, using tests for continuous variables and χ tests for categorical variables. Unadjusted and adjusted logistic regression models were used to understand the impact of tobacco status on revision surgery.
The final analysis included 34 350 patients (29 916 CRS with no revision surgery and 4434 CRS with revision surgery). Unadjusted regression analysis demonstrated an increased odds of undergoing revision ESS (OR 1.12, 95% CI: 1.00-1.25, = .05) among males with a history of tobacco use and CRS. Adjusted regression analysis demonstrated that the risk of revision ESS among CRS patients with a history of asthma and tobacco use was 1.72-fold, while the risk among CRS patients who were tobacco users without asthma was 1.11-fold.
History of tobacco use is an independent risk factor for revision ESS among patients with CRS.
大型流行病学研究表明，吸烟史可能与慢性鼻-鼻窦炎（CRS）发病风险增加有关。然而，吸烟对鼻内镜鼻窦手术（ESS）翻修率的影响仍不明确。
本研究旨在明确大量CRS患者中吸烟（现吸或既往吸烟）对ESS翻修率的独立影响。
检索某州人口数据库，纳入1996年至2018年间年龄≥18岁且接受过至少1次ESS的CRS患者。对CRS患者的人口统计学特征、ESS史和吸烟状况进行比较，连续变量采用检验，分类变量采用χ检验。采用未校正和校正的逻辑回归模型来了解吸烟状况对翻修手术的影响。
最终分析纳入34350例患者（29916例未行翻修手术的CRS患者和4434例接受翻修手术的CRS患者）。未校正回归分析显示，有吸烟史的男性CRS患者接受ESS翻修的几率增加（OR 1.12，95%CI：1.00-1.25，P=0.05）。校正回归分析显示，有哮喘和吸烟史的CRS患者接受ESS翻修的风险是1.72倍，而无哮喘的吸烟CRS患者的风险是1.11倍。
吸烟史是CRS患者ESS翻修的独立危险因素。
