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Otolaryngol Head Neck Surg. 2017 Apr;156(4):751-756. doi: 10.1177/0194599817691476. Epub 2017 Feb 14.

CHEER National Study of Chronic Rhinosinusitis Practice Patterns: Disease Comorbidities and Factors Associated with Surgery.

Author information

1
1 Division of Head and Neck Surgery and Communication Sciences, Duke University Medical Center, Durham, North Carolina, USA.
2
2 Department of Otolaryngology, University of Michigan, Ann Arbor, Michigan, USA.
3
3 Duke Clinical Research Institute, Durham, North Carolina, USA.
4
4 Division of Otolaryngology, Harvard Medical School, Boston, Massachusetts, USA.
5
5 Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of Connecticut Health Center, Farmington, Connecticut, USA.
6
6 Department of Otolaryngology, University of Washington, Seattle, Washington, USA.
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7 Department of Otolaryngology, Hofstra North Shore-LIJ School of Medicine, Long Island Jewish Medical Center, New Hyde Park, New York, USA.
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8 Department of Otolaryngology-Head and Neck Surgery, Oregon Health and Science University, Portland, Oregon, USA.

Abstract

Objectives (1) Describe national patterns of chronic rhinosinusitis (CRS) care across academic and community practices. (2) Determine the prevalence of comorbid disorders in CRS patients, including nasal polyposis, allergic rhinitis, asthma, and cystic fibrosis. (3) Identify demographic, clinical, and practice type factors associated with endoscopic sinus surgery (ESS). Study Design Multisite cross-sectional study. Setting Otolaryngology's national research network CHEER (Creating Healthcare Excellence through Education and Research). Subjects and Methods A total of 17,828 adult patients with CRS were identified, of which 10,434 were seen at community practices (59%, n = 8 sites) and 7394 at academic practices (41%, n = 10 sites). Multivariate logistic regression was used to evaluate the association between demographic, practice type, and clinical factors and the odds of a patient undergoing ESS. Results The average age was 50.4 years; 59.5% of patients were female; and 88.3% were Caucasian. The prevalence of comorbid diseases was as follows: allergic rhinitis (35.1%), nasal polyposis (13.3%), asthma (4.4%), and cystic fibrosis (0.2%). In addition, 24.8% of patients at academic centers underwent ESS, as compared with 12.3% at community sites. In multivariate analyses, nasal polyposis (odds ratio [OR], 4.28), cystic fibrosis (OR, 2.42), and academic site type (OR, 1.86) were associated with ESS ( P < .001), while adjusting for other factors. Conclusions We describe practice patterns of CRS care, as well as demographic and clinical factors associated with ESS. This is the first study of practice patterns in CRS utilizing the CHEER network and may be used to guide future research.

KEYWORDS:

CHEER; CRS; ESS; FESS; academic; chronic rhinosinusitis; clinical practice guidelines; community; disease comorbidities; national research network; sinus surgery

PMID:
28195023
PMCID:
PMC5378587
DOI:
10.1177/0194599817691476
[Indexed for MEDLINE]
Free PMC Article

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