PMID- 30548212
OWN - NLM
STAT- MEDLINE
DCOM- 20200117
LR  - 20200309
IS  - 2042-6984 (Electronic)
IS  - 2042-6976 (Print)
IS  - 2042-6976 (Linking)
VI  - 9
IP  - 3
DP  - 2019 Mar
TI  - Socioeconomic factors impact quality of life outcomes and olfactory measures in 
      chronic rhinosinusitis.
PG  - 231-239
LID - 10.1002/alr.22256 [doi]
AB  - BACKGROUND: Healthcare disparities related to socioeconomic factors may adversely 
      impact disease states and treatment outcomes. Among patients with chronic 
      rhinosinusitis (CRS), the impact of socioeconomic factors on outcomes following 
      endoscopic sinus surgery (ESS) remains uncertain. METHODS: Adult patients with 
      refractory CRS were prospectively enrolled into an observational, 
      multi-institutional cohort study between March 2011 and June 2015. Socioeconomic 
      factors analyzed included household income, insurance status, years of education 
      completed, race, age, and ethnicity. Income was stratified according to the 
      Thompson and Hickey model. The 22-item Sino-Nasal Outcome Test (SNOT-22) and 
      Brief Smell Identification Test (BSIT) were completed preoperatively and 
      postoperatively. RESULTS: A total of 392 patients met inclusion criteria. Higher 
      age and male gender were associated with better mean preoperative SNOT-22 scores 
      (both p < 0.02), whereas Medicare insurance status and male gender were 
      associated with worse preoperative mean BSIT scores (both p < 0.02). 
      Postoperatively, higher household income ($100,001+/year) and lower age were 
      associated with a greater likelihood of improving at least 1 minimal clinically 
      important difference (MCID) on SNOT-22 scores (OR = 2.40 and 1.03, respectively, 
      both p < 0.05), while no factors were associated with increased odds of achieving 
      a MCID on BSIT scores. CONCLUSIONS: Preoperative olfactory function and 
      postoperative quality of life (QOL) improvement were associated with metrics of 
      socioeconomic status in patients with CRS electing ESS. The odds of experiencing 
      a clinically meaningful QOL improvement were more than twice as likely for 
      patients with the highest household income level compared to other income tiers. 
      Further investigation is warranted to identify barriers to postoperative 
      improvement.
CI  - (c) 2018 ARS-AAOA, LLC.
FAU - Beswick, Daniel M
AU  - Beswick DM
AD  - Department of Otolaryngology, University of Colorado, Aurora, CO.
FAU - Mace, Jess C
AU  - Mace JC
AD  - Division of Rhinology and Sinus/Skull Base Surgery, Department of 
      Otolaryngology-Head and Neck Surgery, Oregon Health and Science University, 
      Portland, OR.
FAU - Rudmik, Luke
AU  - Rudmik L
AD  - Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, Cumming 
      School of Medicine, University of Calgary, Calgary, Alberta, Canada.
FAU - Soler, Zachary M
AU  - Soler ZM
AD  - Department of Otolaryngology-Head and Neck Surgery, Medical University of South 
      Carolina, Charleston, SC.
FAU - Alt, Jeremiah A
AU  - Alt JA
AUID- ORCID: 0000-0003-0560-5028
AD  - Sinus and Skull Base Surgery Program, Division of Otolaryngology-Head and Neck 
      Surgery, Department of Surgery, University of Utah, Salt Lake City, UT.
FAU - Smith, Kristine A
AU  - Smith KA
AUID- ORCID: 0000-0002-7026-5819
AD  - Department of Otolaryngology-Head and Neck Surgery, University of Manitoba, 
      Winnipeg, Manitoba, Canada.
FAU - Detwiller, Kara Y
AU  - Detwiller KY
AD  - Division of Rhinology and Sinus/Skull Base Surgery, Department of 
      Otolaryngology-Head and Neck Surgery, Oregon Health and Science University, 
      Portland, OR.
FAU - Smith, Timothy L
AU  - Smith TL
AUID- ORCID: 0000-0002-6424-7083
AD  - Division of Rhinology and Sinus/Skull Base Surgery, Department of 
      Otolaryngology-Head and Neck Surgery, Oregon Health and Science University, 
      Portland, OR.
LA  - eng
GR  - R01 DC005805/DC/NIDCD NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
DEP - 20181210
PL  - United States
TA  - Int Forum Allergy Rhinol
JT  - International forum of allergy & rhinology
JID - 101550261
SB  - IM
MH  - Adult
MH  - Aged
MH  - Chronic Disease
MH  - Cohort Studies
MH  - *Endoscopy
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Paranasal Sinuses/*surgery
MH  - Prospective Studies
MH  - Quality of Life
MH  - Rhinitis/*epidemiology/surgery
MH  - Sinusitis/*epidemiology/surgery
MH  - Smell
MH  - *Socioeconomic Factors
MH  - Treatment Outcome
PMC - PMC6397069
MID - NIHMS997457
OTO - NOTNLM
OT  - chronic disease
OT  - outcome assessment (health care)
OT  - quality of life
OT  - sinusitis
OT  - socioeconomic factors
OT  - symptom assessment
COIS- Potential Conflicts of Interest: None
EDAT- 2018/12/15 06:00
MHDA- 2020/01/18 06:00
PMCR- 2020/03/01
CRDT- 2018/12/15 06:00
PHST- 2018/08/31 00:00 [received]
PHST- 2018/10/31 00:00 [revised]
PHST- 2018/11/13 00:00 [accepted]
PHST- 2018/12/15 06:00 [pubmed]
PHST- 2020/01/18 06:00 [medline]
PHST- 2018/12/15 06:00 [entrez]
PHST- 2020/03/01 00:00 [pmc-release]
AID - 10.1002/alr.22256 [doi]
PST - ppublish
SO  - Int Forum Allergy Rhinol. 2019 Mar;9(3):231-239. doi: 10.1002/alr.22256. Epub 
      2018 Dec 10.