Upfront Draf III Strategy Often Less Costly for Severe CRS Requiring Surgery.

IF 2.3 3区 医学 Q1 OTORHINOLARYNGOLOGY
American Journal of Rhinology & Allergy Pub Date : 2025-09-01 Epub Date: 2025-05-04 DOI:10.1177/19458924251337788
David K Lerner, Saawan Patel, Chau Phung, Alan D Workman, Glenn Pennington, Robert Stetson, Jennifer E Douglas, Michael A Kohanski, Nithin D Adappa, James N Palmer
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引用次数: 0

Abstract

BackgroundDraf III procedures are considered to be time- and supply-intensive compared to standard functional endoscopic sinus surgery (FESS).ObjectiveTo quantify the cost of a Draf III compared to standard FESS and examine time- and supply-related cost factors.MethodsWe performed a retrospective analysis of inflammatory sinus surgeries at a tertiary care medical center from July 2021 to July 2023. The medical record was reviewed for patient factors and cost variables, and multivariable analysis was performed.ResultsThree hundred and fifty patients were included with a mean age of 50.6 years. One hundred and twenty-nine patients underwent a Draf III, 99 of whom (76.7%) underwent a Draf III as part of a full FESS whereas 30 (23.3%) underwent a targeted revision Draf III. Among all Draf III procedures, operating room and supply costs represented 63.1% ($6231.67) and 16.6% ($1638.46) of total costs, respectively, compared to 54.8% ($4912.46) and 14.5% ($1296.06) for standard FESS (both p < .001). The average total cost for a full FESS with Draf III was $10118.60, compared to $9414.29 for a targeted Draf III, and $8960.31 for standard FESS (n = 221). Using these values, we calculated that the approach of performing an upfront Draf III would be less costly relative to the approach of performing standard FESS with Draf II and then revision Draf III as needed when the expected revision rate exceeds 12.3%.ConclusionsSurgical costs associated with a FESS with Draf III are driven primarily by operating room time costs, to a greater degree even than for standard FESS. The cost of performing a full FESS with Draf III is not considerably higher than a standard FESS or a targeted Draf III revision, suggesting that an upfront Draf III may represent a relatively less costly treatment approach for patients at high risk of recurrent frontal disease.

对于需要手术的严重CRS,前期草案III策略通常成本较低。
与标准功能性内窥镜鼻窦手术(FESS)相比,draft III手术被认为是时间和供应密集的。目的与标准FESS相比,量化草案III的成本,并审查与时间和供应相关的成本因素。方法回顾性分析2021年7月至2023年7月在某三级医疗中心进行的炎症性鼻窦手术。对病历进行了患者因素和成本变量的审查,并进行了多变量分析。结果纳入350例患者,平均年龄50.6岁。129例患者接受了草案III,其中99例(76.7%)接受了草案III作为完整FESS的一部分,而30例(23.3%)接受了有针对性的修订草案III。在所有草案III程序中,手术室和供应成本分别占总成本的63.1%(6231.67美元)和16.6%(1638.46美元),而标准FESS为54.8%(4912.46美元)和14.5%(1296.06美元)
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来源期刊
CiteScore
5.60
自引率
11.50%
发文量
82
审稿时长
4-8 weeks
期刊介绍: The American Journal of Rhinology & Allergy is a peer-reviewed, scientific publication committed to expanding knowledge and publishing the best clinical and basic research within the fields of Rhinology & Allergy. Its focus is to publish information which contributes to improved quality of care for patients with nasal and sinus disorders. Its primary readership consists of otolaryngologists, allergists, and plastic surgeons. Published material includes peer-reviewed original research, clinical trials, and review articles.
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