Abstract：
BACKGROUND: Allergic fungal rhinosinusitis (AFRS) is a subtype of chronic rhinosinusitis (CRS) that has previously been associated with younger age and Black patients. However, the role of demographic and socioeconomic factors in AFRS severity remains to be fully elucidated.
OBJECTIVE: The objective of this study was to determine whether demographic and socioeconomic factors are associated with incidence of AFRS, as well as with disease severity in Northern California.
METHODS: A retrospective cohort study was conducted of adult patients with AFRS and CRS from 2010 to 2019. AFRS was determined by the Bent and Kuhn criteria, and severity was assessed by radiographic evidence of cranioorbital invasion and other clinical parameters. Chi-square and t-test were used to assess demographic and socioeconomic differences between AFRS and CRS cohorts, and multivariable logistic regression was used to assess risk factors for severe AFRS.
RESULTS: Black patients represented 26.2% (55/210 patients) of the AFRS group and 4.9% (842/17,300 patients) of the CRS group, with pairwise comparison of race/ethnicity categories showing that the AFRS group had significantly higher proportions of Black race/ethnicity compared with other race/ethnicities (p < 0.01). AFRS and CRS groups differed significantly by age, with mean ages of 48.7 and 51.0 years, respectively (p = 0.04). There were no significant differences in gender, Medicaid status, comorbidities, and socioeconomic status measures. Multivariate logistic regression showed that Black patients had higher odds of having severe AFRS (adjusted odds ratio = 2.29; 95% confidence interval: 1.18-4.45).
CONCLUSIONS: AFRS has a unique predilection for Black patients, and severe disease is also more likely in this population.
OBJECTIVE: The objective of this study was to determine whether demographic and socioeconomic factors are associated with incidence of AFRS, as well as with disease severity in Northern California.
METHODS: A retrospective cohort study was conducted of adult patients with AFRS and CRS from 2010 to 2019. AFRS was determined by the Bent and Kuhn criteria, and severity was assessed by radiographic evidence of cranioorbital invasion and other clinical parameters. Chi-square and t-test were used to assess demographic and socioeconomic differences between AFRS and CRS cohorts, and multivariable logistic regression was used to assess risk factors for severe AFRS.
RESULTS: Black patients represented 26.2% (55/210 patients) of the AFRS group and 4.9% (842/17,300 patients) of the CRS group, with pairwise comparison of race/ethnicity categories showing that the AFRS group had significantly higher proportions of Black race/ethnicity compared with other race/ethnicities (p < 0.01). AFRS and CRS groups differed significantly by age, with mean ages of 48.7 and 51.0 years, respectively (p = 0.04). There were no significant differences in gender, Medicaid status, comorbidities, and socioeconomic status measures. Multivariate logistic regression showed that Black patients had higher odds of having severe AFRS (adjusted odds ratio = 2.29; 95% confidence interval: 1.18-4.45).
CONCLUSIONS: AFRS has a unique predilection for Black patients, and severe disease is also more likely in this population.
摘要：
背景：过敏性真菌性鼻-鼻窦炎（AFRS）是慢性鼻-鼻窦炎（CRS）的一种亚型，以前与年龄较小和黑人患者有关。然而,人口统计学和社会经济因素在AFRS严重程度中的作用仍有待充分阐明。
目的：本研究的目的是确定人口统计学和社会经济因素是否与AFRS的发病率相关。以及北加州的疾病严重程度。
方法：对2010年至2019年患有AFRS和CRS的成年患者进行了回顾性队列研究。AFRS由Bent和Kuhn标准确定，严重程度通过颅眶侵犯的影像学证据和其他临床参数进行评估.卡方和t检验用于评估AFRS和CRS队列之间的人口统计学和社会经济差异，多变量logistic回归用于评估严重AFRS的危险因素。
结果：黑人患者占AFRS组的26.2%（55/210患者）和CRS组的4.9%（842/17,300患者），种族/种族类别的成对比较显示，AFRS组的黑人种族/种族比例明显高于其他种族/种族（p<0.01）。AFRS和CRS组的年龄差异显着，平均年龄为48.7岁和51.0岁，分别(p=0.04)。性别差异不显著,医疗补助状况,合并症,和社会经济地位措施。多因素logistic回归分析显示，Black患者发生严重AFRS的几率较高（校正比值比=2.29；95%置信区间：1.18-4.45）。
结论：AFRS对黑人患者有独特的偏好，在这个人群中，严重疾病的可能性也更大。
目的：本研究的目的是确定人口统计学和社会经济因素是否与AFRS的发病率相关。以及北加州的疾病严重程度。
方法：对2010年至2019年患有AFRS和CRS的成年患者进行了回顾性队列研究。AFRS由Bent和Kuhn标准确定，严重程度通过颅眶侵犯的影像学证据和其他临床参数进行评估.卡方和t检验用于评估AFRS和CRS队列之间的人口统计学和社会经济差异，多变量logistic回归用于评估严重AFRS的危险因素。
结果：黑人患者占AFRS组的26.2%（55/210患者）和CRS组的4.9%（842/17,300患者），种族/种族类别的成对比较显示，AFRS组的黑人种族/种族比例明显高于其他种族/种族（p<0.01）。AFRS和CRS组的年龄差异显着，平均年龄为48.7岁和51.0岁，分别(p=0.04)。性别差异不显著,医疗补助状况,合并症,和社会经济地位措施。多因素logistic回归分析显示，Black患者发生严重AFRS的几率较高（校正比值比=2.29；95%置信区间：1.18-4.45）。
结论：AFRS对黑人患者有独特的偏好，在这个人群中，严重疾病的可能性也更大。
