Radiographic disease severity in chronic rhinosinusitis patients and health care utilization.
Radiographic disease severity in chronic rhinosinusitis patients and health care utilization.
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DOI：
10.1002/lio2.663
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发表时间：
2021-10
影响因子：
1.9
通讯作者：
Tan BK
中科院分区：
文献类型：
--
作者：
Mehta MP;Hur K;Price CPE;Shintani-Smith S;Welch KC;Conley DB;Kern RC;Tan BK
在美国，慢性鼻-鼻窦炎(CRS)影响了大约12%的人口，导致医疗保健利用率增加，间接成本每年超过200亿美元。Lund-Mackay评分(LMS)衡量CRS的放射学疾病严重程度，但与症状评分相关性较差。在CRS患者中，LMS和卫生保健利用之间的关系尚未被调查。这项研究旨在使用LMS评估卫生保健利用与CRS放射学严重程度之间的关系。对登记在临床登记处的CRS患者进行评估。对接受鼻窦CT成像的患者记录鼻内窥镜检查结果和LMS。收集患者症状评分、人口学特征和卫生保健利用措施。对这些因素与LMS的关系进行了研究。共有556名患者符合纳入标准。平均年龄45.3 岁，男性占53.4%，鼻息肉占41.7%。高(≥8，n=410)和低(<；8，n=1 146)LMS患者在性别、吸烟史、22项鼻咽结局测验得分和既往病史因素方面无差异。在高LMS患者中，73.7%的患者接受了鼻内窥镜手术(P <； .01)，而在低LMS患者中，55.5%的患者接受了鼻内窥镜手术(P <； .01)，鼻息肉的比例也更高(49.3%vs20.5%，P<0.05)。多因素Logistic回归分析显示，与低LMS患者相比，高LMS患者使用抗生素疗程较少(OR：0.68[0.51~0.91])，但更容易接受ESS治疗(OR：2.28[1.41~3.73])，并有鼻息肉(OR：2.11[1.16~3.93])。两个LMS组在类固醇疗程的数量、非处方药的使用、提供者就诊、缺勤天数或症状持续时间方面没有显著差异。患有严重放射疾病的CRS患者更有可能患有鼻息肉，接受ESS，并较少服用抗生素疗程。然而，放射学疾病的严重程度与卫生保健利用的其他指标之间没有关联。2B、个体回顾性队列研究。
Chronic rhinosinusitis (CRS) affects approximately 12% of the population and leads to increased health care utilization and indirect costs exceeding $20 billion annually in the United States. The Lund‐Mackay score (LMS) measures radiographic disease severity for CRS but poorly correlates with symptom scores. The association between LMS and health care utilization in CRS patients has not yet been investigated. The study aimed to assess the association between health care utilization and CRS radiographic severity using LMS. CRS patients enrolled in a clinical registry were evaluated. Nasal endoscopy findings and LMS were recorded for patients with sinus CT imaging. Patient symptom scores, demographic characteristics, and health care utilization measures were collected. The relationship between these factors and LMS was examined. A total of 556 patients met inclusion criteria. Mean age was 45.3 years, 53.4% were male, and 41.7% had nasal polyps. There was no difference in sex, smoking history, 22‐item Sino‐nasal Outcome Test scores, or past medical history factors between patients with high (≥8, n = 410) and low (<8, n = 146) LMS. Among high LMS patients, 73.7% underwent endoscopic sinus surgery (ESS) compared to 55.5% with low LMS (P < .01), and a greater percentage of patients had nasal polyps (49.3% vs 20.5%, P < .01). On multivariable logistic regression, high LMS patients used fewer antibiotic courses (OR: 0.68 [0.51‐0.91]), but were more likely to be managed with ESS (OR: 2.28 [1.41‐3.73]), and have nasal polyps (OR: 2.11 [1.16‐3.93]) compared to low LMS patients. There was no significant difference in the number of steroid courses, over the counter pill use, provider visits, work/school days missed, or symptom duration between the two LMS groups. CRS patients with severe radiographic disease are more likely to have nasal polyps, undergo ESS, and take fewer antibiotic courses. However, there is no association between radiographic disease severity and other measures of health care utilization. 2b, individual retrospective cohort study.
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影响因子：
12.4
作者：
Hirsch AG;Stewart WF;Sundaresan AS;Young AJ;Kennedy TL;Scott Greene J;Feng W;Tan BK;Schleimer RP;Kern RC;Lidder A;Schwartz BS
通讯作者：
Schwartz BS
影响因子：
6.4
作者：
Weibman AR;Huang JH;Stevens WW;Suh LA;Price CPE;Lidder AK;Conley DB;Welch KC;Shintani-Smith S;Peters AT;Grammer LC;Kato A;Kern RC;Schleimer RP;Tan BK
通讯作者：
Tan BK
影响因子：
6.4
作者：
John Staniorski C;Price CPE;Weibman AR;Welch KC;Conley DB;Shintani-Smith S;Stevens WW;Peters AT;Grammer L;Lidder AK;Schleimer RP;Kern RC;Tan BK
通讯作者：
Tan BK
DOI：
10.1007/s12070-017-1232-0
发表时间：
2017-12-01
影响因子：
0.6
作者：
Deosthale, Nitin V.;Khadakkar, Sonali P.;Katke, Ashwini B.
通讯作者：
Katke, Ashwini B.
影响因子：
2.6
作者：
Kuan, Edward C.;Tajudeen, Bobby A.;Wang, Marilene B.
通讯作者：
Wang, Marilene B.