Benjamin F Bitner, Sina J Torabi, Theodore V Nguyen, Jonathan C Pang, Edward C Kuan
{"title":"功能性内窥镜鼻窦手术和球囊鼻窦成形术的趋势和并发症：TriNetX数据库分析。","authors":"Benjamin F Bitner, Sina J Torabi, Theodore V Nguyen, Jonathan C Pang, Edward C Kuan","doi":"10.1002/wjo2.222","DOIUrl":null,"url":null,"abstract":"<p><strong>Objectives: </strong>Balloon sinuplasty (BSP) and functional endoscopic sinus surgery (FESS) have undergone changes in utilization over time. This study investigates national trends in BSP and FESS and postoperative outcomes over the last decade as well as the impact of Corona Virus Disease 2019 (COVID-19) on these trends.</p><p><strong>Methods: </strong>The TriNetX database was queried for patients undergoing either FESS or BSP from 1/1/2011 to 5/4/2024. Data were collected on patient demographics, diagnoses, and postoperative outcomes.</p><p><strong>Results: </strong>A total of 1738 patients underwent BSP and 90,311 underwent FESS. A greater proportion of FESS patients had diabetes (<i>p</i> = 0.001), hypertension (<i>p</i> < 0.001), and chronic pulmonary disease, <i>p</i> = 0.001) compared to BSP whereas a similar proportion of patients for both cohorts had a history of ischemic heart disease (<i>p</i> = 0.73). Body mass index was higher for patients undergoing FESS (28.6 ± 6.5) compared to BSP (28.1 ± 6.578; <i>p</i> = 0.02). Overall postoperative complications were similar between BSP and FESS (odds ratio [OR] = 0.80, 95% confidence interval [CI] = 0.58-1.09) with similar rates of epistaxis (OR = 0.77, 95% CI = 0.53-1.12) and cerebrospinal fluid (CSF) leak (OR = 0.14, 95% CI = 0.01-2.25). Overall revision rate was higher for FESS (OR = 0.34, 95% CI = 0.21-0.57). Thirty-day readmission (OR = 0.44, 95% CI = 0.29-0.66) and Emergency Department visits (OR = 0.51, 95% CI = 0.28-0.92) were less common in patients who received BSP. Surgical volume consistently increased over time for both cohorts but at a more rapid pace for BSP (425.64%) compared to FESS (274.19%) and a dramatic decrease in volume by 44.85% and 22.28%, respectively, at the onset of COVID-19.</p><p><strong>Conclusion: </strong>Overall, BSP and FESS surgical volume have steadily increased over time with a drastic reduction following the COVID-19 pandemic. BSP and FESS carry different complication profiles emphasizing the importance of patient selection and preoperative counseling.</p><p><strong>Level of evidence: </strong>Level 4.</p>","PeriodicalId":32097,"journal":{"name":"World Journal of OtorhinolaryngologyHead and Neck Surgery","volume":"11 3","pages":"368-374"},"PeriodicalIF":1.4000,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12418347/pdf/","citationCount":"0","resultStr":"{\"title\":\"Trends and complications in functional endoscopic sinus surgery and balloon sinuplasty: A TriNetX database analysis.\",\"authors\":\"Benjamin F Bitner, Sina J Torabi, Theodore V Nguyen, Jonathan C Pang, Edward C Kuan\",\"doi\":\"10.1002/wjo2.222\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objectives: </strong>Balloon sinuplasty (BSP) and functional endoscopic sinus surgery (FESS) have undergone changes in utilization over time. This study investigates national trends in BSP and FESS and postoperative outcomes over the last decade as well as the impact of Corona Virus Disease 2019 (COVID-19) on these trends.</p><p><strong>Methods: </strong>The TriNetX database was queried for patients undergoing either FESS or BSP from 1/1/2011 to 5/4/2024. Data were collected on patient demographics, diagnoses, and postoperative outcomes.</p><p><strong>Results: </strong>A total of 1738 patients underwent BSP and 90,311 underwent FESS. A greater proportion of FESS patients had diabetes (<i>p</i> = 0.001), hypertension (<i>p</i> < 0.001), and chronic pulmonary disease, <i>p</i> = 0.001) compared to BSP whereas a similar proportion of patients for both cohorts had a history of ischemic heart disease (<i>p</i> = 0.73). Body mass index was higher for patients undergoing FESS (28.6 ± 6.5) compared to BSP (28.1 ± 6.578; <i>p</i> = 0.02). Overall postoperative complications were similar between BSP and FESS (odds ratio [OR] = 0.80, 95% confidence interval [CI] = 0.58-1.09) with similar rates of epistaxis (OR = 0.77, 95% CI = 0.53-1.12) and cerebrospinal fluid (CSF) leak (OR = 0.14, 95% CI = 0.01-2.25). Overall revision rate was higher for FESS (OR = 0.34, 95% CI = 0.21-0.57). Thirty-day readmission (OR = 0.44, 95% CI = 0.29-0.66) and Emergency Department visits (OR = 0.51, 95% CI = 0.28-0.92) were less common in patients who received BSP. Surgical volume consistently increased over time for both cohorts but at a more rapid pace for BSP (425.64%) compared to FESS (274.19%) and a dramatic decrease in volume by 44.85% and 22.28%, respectively, at the onset of COVID-19.</p><p><strong>Conclusion: </strong>Overall, BSP and FESS surgical volume have steadily increased over time with a drastic reduction following the COVID-19 pandemic. BSP and FESS carry different complication profiles emphasizing the importance of patient selection and preoperative counseling.</p><p><strong>Level of evidence: </strong>Level 4.</p>\",\"PeriodicalId\":32097,\"journal\":{\"name\":\"World Journal of OtorhinolaryngologyHead and Neck Surgery\",\"volume\":\"11 3\",\"pages\":\"368-374\"},\"PeriodicalIF\":1.4000,\"publicationDate\":\"2024-12-04\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12418347/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"World Journal of OtorhinolaryngologyHead and Neck Surgery\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1002/wjo2.222\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/9/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q2\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"World Journal of OtorhinolaryngologyHead and Neck Surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1002/wjo2.222","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/9/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"Medicine","Score":null,"Total":0}
引用次数: 0
摘要
目的：球囊鼻窦成形术（BSP）和功能性内窥镜鼻窦手术（FESS）的应用随着时间的推移发生了变化。本研究调查了过去十年来BSP和FESS的全国趋势和术后结果，以及2019冠状病毒病（COVID-19）对这些趋势的影响。方法：查询TriNetX数据库2011年1月1日至2024年5月4日期间接受FESS或BSP治疗的患者。收集患者人口统计学、诊断和术后结果的数据。结果：BSP患者1738例，FESS患者90311例。与BSP相比，FESS患者有糖尿病（p = 0.001）和高血压（p = 0.001）的比例更高，而两个队列中有缺血性心脏病史的患者比例相似（p = 0.73）。FESS组体重指数（28.6±6.5）高于BSP组（28.1±6.578;p = 0.02）。BSP和FESS的总体术后并发症相似（优势比[OR] = 0.80, 95%可信区间[CI] = 0.58-1.09），鼻出血（OR = 0.77, 95% CI = 0.53-1.12）和脑脊液（CSF）泄漏（OR = 0.14, 95% CI = 0.01-2.25）发生率相似。FESS的总体修正率更高（OR = 0.34, 95% CI = 0.21-0.57）。30天再入院（OR = 0.44, 95% CI = 0.29-0.66）和急诊就诊（OR = 0.51, 95% CI = 0.28-0.92）在接受BSP的患者中较少见。随着时间的推移，两个队列的手术量持续增加，但BSP的手术量（425.64%）比FESS（274.19%）更快，在COVID-19发病时，手术量分别急剧下降44.85%和22.28%。结论：总体而言，BSP和FESS手术量随着时间的推移稳步增加，在COVID-19大流行后急剧减少。BSP和FESS具有不同的并发症概况，强调患者选择和术前咨询的重要性。证据等级：四级。
Trends and complications in functional endoscopic sinus surgery and balloon sinuplasty: A TriNetX database analysis.
Objectives: Balloon sinuplasty (BSP) and functional endoscopic sinus surgery (FESS) have undergone changes in utilization over time. This study investigates national trends in BSP and FESS and postoperative outcomes over the last decade as well as the impact of Corona Virus Disease 2019 (COVID-19) on these trends.
Methods: The TriNetX database was queried for patients undergoing either FESS or BSP from 1/1/2011 to 5/4/2024. Data were collected on patient demographics, diagnoses, and postoperative outcomes.
Results: A total of 1738 patients underwent BSP and 90,311 underwent FESS. A greater proportion of FESS patients had diabetes (p = 0.001), hypertension (p < 0.001), and chronic pulmonary disease, p = 0.001) compared to BSP whereas a similar proportion of patients for both cohorts had a history of ischemic heart disease (p = 0.73). Body mass index was higher for patients undergoing FESS (28.6 ± 6.5) compared to BSP (28.1 ± 6.578; p = 0.02). Overall postoperative complications were similar between BSP and FESS (odds ratio [OR] = 0.80, 95% confidence interval [CI] = 0.58-1.09) with similar rates of epistaxis (OR = 0.77, 95% CI = 0.53-1.12) and cerebrospinal fluid (CSF) leak (OR = 0.14, 95% CI = 0.01-2.25). Overall revision rate was higher for FESS (OR = 0.34, 95% CI = 0.21-0.57). Thirty-day readmission (OR = 0.44, 95% CI = 0.29-0.66) and Emergency Department visits (OR = 0.51, 95% CI = 0.28-0.92) were less common in patients who received BSP. Surgical volume consistently increased over time for both cohorts but at a more rapid pace for BSP (425.64%) compared to FESS (274.19%) and a dramatic decrease in volume by 44.85% and 22.28%, respectively, at the onset of COVID-19.
Conclusion: Overall, BSP and FESS surgical volume have steadily increased over time with a drastic reduction following the COVID-19 pandemic. BSP and FESS carry different complication profiles emphasizing the importance of patient selection and preoperative counseling.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
