National Trends in Chronic Rhinosinusitis and Inpatient Sinus Surgery in Adults with Cystic Fibrosis.

IF 1.8 Q2 OTORHINOLARYNGOLOGY

OTO Open Pub Date : 2025-02-20 eCollection Date: 2025-01-01 DOI:10.1002/oto2.70064

Roy W Qu, Nihal Punjabi, Wilson P Lao, Kristin A Seiberling, Christopher A Church

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Abstract

Objective: Given the recent dramatic changes in medical therapy for cystic fibrosis (CF), this study aims to describe temporal changes in chronic rhinosinusitis (CRS) and endoscopic sinus surgery (ESS) rates.

Methods: National Inpatient Sample (2004-2019; weighted estimates for 119,067 pediatric and 202,407 adult patients) was used to analyze adult (age ≥18 years) and pediatric patients with CF with pulmonary manifestations. Comorbid CRS, ESS rates, and extended length of stay (LOS, ≥75th percentile) were analyzed.

Results: The rate of CRS in both pediatric (14.1% vs 21.1%, P < .001) and adult (16.5% vs 40.9%, P < .001) patients increased. Rate of ESS in pediatric patients with CRS decreased from 25.3% to 3.4% (P < .001). A similar decline occurred in adults with CRS (12.3% vs 3.6%, P < .001). In multivariate analysis from 2015 to 2019, ESS and extended LOS were associated with admission in the Western United States (P < .001). CRS (OR 1.14, P = .002) and ESS (OR 1.78, P = .002) were independent predictors of extended LOS. Elective admission, primary insurance, race, and hospital teaching/location were significantly associated with ESS and extended LOS (P < .05).

Conclusion: Despite the increased prevalence of CRS in adults and pediatric patients with CF, rates of inpatient ESS have declined from 2004 to 2019. Patient and hospital factors affect undergoing ESS in 2015 to 2019. CRS and ESS are associated with extended LOS in recent years.

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囊性纤维化成人慢性鼻窦炎和住院鼻窦手术的全国趋势。

目的：鉴于最近囊性纤维化（CF）的药物治疗发生了巨大变化，本研究旨在描述慢性鼻窦炎（CRS）和内窥镜鼻窦手术（ESS）率的时间变化。方法：2004-2019年全国住院患者样本；对119,067名儿童和202,407名成人患者进行加权估计，分析成人（年龄≥18岁）和儿童CF伴肺表现的患者。分析合并症CRS、ESS率和延长住院时间（LOS，≥75百分位）。结果：儿童CRS发生率（14.1% vs 21.1%, P P P P P P = .002）和ESS （OR 1.78, P = .002）是延长LOS的独立预测因子。选择性住院、基本保险、种族和医院教学/地点与ESS和延长的LOS显著相关(P结论：尽管成人和儿童CF患者的CRS患病率增加，但住院ESS的比例从2004年到2019年有所下降。患者和医院因素影响2015年至2019年接受ESS。近年来，CRS和ESS与扩展的LOS有关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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