Department of Otolaryngology-Head and Neck Surgery, Kaiser Permanente Oakland Medical Center, Oakland, CA, USA.
Rutgers New Jersey Medical School, Newark, NJ, USA.
Perm J. 2024 Jun 14;28(2):78-85. doi: 10.7812/TPP/23.165. Epub 2024 May 15.
Allergic fungal rhinosinusitis (AFRS) is a subtype of chronic rhinosinusitis (CRS) that has previously been associated with younger age and Black patients. However, the role of demographic and socioeconomic factors in AFRS severity remains to be fully elucidated.
The objective of this study was to determine whether demographic and socioeconomic factors are associated with incidence of AFRS, as well as with disease severity in Northern California.
A retrospective cohort study was conducted of adult patients with AFRS and CRS from 2010 to 2019. AFRS was determined by the Bent and Kuhn criteria, and severity was assessed by radiographic evidence of cranioorbital invasion and other clinical parameters. Chi-square and t-test were used to assess demographic and socioeconomic differences between AFRS and CRS cohorts, and multivariable logistic regression was used to assess risk factors for severe AFRS.
Black patients represented 26.2% (55/210 patients) of the AFRS group and 4.9% (842/17,300 patients) of the CRS group, with pairwise comparison of race/ethnicity categories showing that the AFRS group had significantly higher proportions of Black race/ethnicity compared with other race/ethnicities (p < 0.01). AFRS and CRS groups differed significantly by age, with mean ages of 48.7 and 51.0 years, respectively (p = 0.04). There were no significant differences in gender, Medicaid status, comorbidities, and socioeconomic status measures. Multivariate logistic regression showed that Black patients had higher odds of having severe AFRS (adjusted odds ratio = 2.29; 95% confidence interval: 1.18-4.45).
AFRS has a unique predilection for Black patients, and severe disease is also more likely in this population.
变应性真菌性鼻鼻窦炎（AFRS）是慢性鼻鼻窦炎（CRS）的一种亚型，以前与年龄较小和黑人患者有关。然而，人口统计学和社会经济因素在 AFRS 严重程度中的作用仍有待充分阐明。
本研究旨在确定人口统计学和社会经济因素是否与北加利福尼亚 AFRS 的发病以及疾病严重程度有关。
对 2010 年至 2019 年期间患有 AFRS 和 CRS 的成年患者进行了回顾性队列研究。通过 Bent 和 Kuhn 标准确定 AFRS，通过颅眶侵袭的放射学证据和其他临床参数评估疾病严重程度。使用卡方检验和 t 检验评估 AFRS 和 CRS 队列之间的人口统计学和社会经济差异，使用多变量逻辑回归评估严重 AFRS 的危险因素。
黑人患者占 AFRS 组的 26.2%（55/210 例患者），占 CRS 组的 4.9%（842/17300 例患者），种族/民族类别之间的两两比较显示，AFRS 组的黑人种族/民族比例明显高于其他种族/民族（p<0.01）。AFRS 和 CRS 组在年龄上存在显著差异，平均年龄分别为 48.7 岁和 51.0 岁（p=0.04）。两组在性别、医疗补助状况、合并症和社会经济地位指标方面无显著差异。多变量逻辑回归显示，黑人患者患有严重 AFRS 的几率更高（调整后的优势比=2.29；95%置信区间：1.18-4.45）。
AFRS 对黑人患者有独特的偏好，并且该人群中严重疾病的可能性也更高。
