Socioeconomic Status Impacts the Prognosis of Chronic Rhinosinusitis Treated by Endoscopic Sinus Surgery: An Observational Cohort Study in Northeast China

Objective

To explore the association between socioeconomic status (SES) and postoperative outcomes in patients with chronic sinusitis (CRS) after functional endoscopic sinus surgery (ESS).

Methods

We conducted an observational cohort study of 1,047 patients with CRS undergoing ESS. Discharged patients were followed up to 72 weeks for all-cause recurrence events. Baseline SES was established based on occupation, education level, and family income of the patients 1 year before the operation. Kaplan–Meier method was used to calculate the recovery rate after ESS, and Cox proportional hazards regression analysis was used to evaluate the relationship between SES and prognosis.

Results

Patients of middle SES had lower unadjusted all-cause recurrence than those of low or high SES; 24-week overall recovery rate was 90.4% [95 % confidence interval (CI): 89.6%–91.2%] in patients of middle SES, 13.5% (95 % CI: 12.8%–14.2%) in patients of low SES, and 31.7% (95 % CI: 30.7%–32.7%) in patients of high SES (both log-rank P < 0.001). After adjustment for covariates, hazard ratios (HRs) were 7.69 (95 % CI: 6.17–9.71, P_trend < 0.001) for all-cause recurrence for low SES versus middle SES, and 6.19 (95 % CI: 4.78–7.93, P_trend < 0.001) for middle SES versus high SES.

Conclusions

Low SES and high SES were more associated with the worse prognosis of CRS patients after ESS than middle SES.