Abstract：
BACKGROUND: Sociodemographic status (SDS) including race/ethnicity and socioeconomic status as approximated by education, income, and insurance status impact pulmonary disease in people with cystic fibrosis (PwCF). The relationship between SDS and chronic rhinosinusitis (CRS) remains understudied.
METHODS: In a prospective, multi-institutional study, adult PwCF completed the 22-Question SinoNasal Outcome Test (SNOT-22), Smell Identification Test (SIT), Questionnaire of Olfactory Disorder Negative Statements (QOD-NS), and Cystic Fibrosis Questionnaire-Revised (CFQ-R). Lund-Kennedy scores, sinus computed tomography, and clinical data were collected. Data were analyzed across race/ethnicity, sex, and socioeconomic factors using multivariate regression.
RESULTS: Seventy-three PwCF participated with a mean age of 34.7 ± 10.9 years and 49 (67.1%) were female. Linear regression identified that elexacaftor/tezacaftor/ivacaftor (ETI) use (β = ‒4.09, 95% confidence interval [CI] [‒6.08, ‒2.11], p < 0.001), female sex (β = ‒2.14, 95% CI [‒4.11, ‒0.17], p = 0.034), and increasing age (β = ‒0.14, 95% CI [‒0.22, ‒0.05], p = 0.003) were associated with lower/better endoscopy scores. Private health insurance (β = 17.76, 95% CI [5.20, 30.32], p = 0.006) and >16 educational years (β = 13.50, 95% CI [2.21, 24.80], p = 0.020) were associated with higher baseline percent predicted forced expiratory volume in one second (ppFEV1). Medicaid/Medicare insurance was associated with worse endoscopy scores, CFQ-R respiratory scores, and ppFEV1 (all p < 0.017), and Hispanic/Latino ethnicity was associated with worse SNOT-22 scores (p = 0.047), prior to adjustment for other cofactors. No other SDS factors were associated with SNOT-22, QOD-NS, or SIT scores.
CONCLUSIONS: Differences in objective measures of CRS severity exist among PwCF related to sex, age, and ETI use. Variant status and race did not influence patient-reported CRS severity measures or olfaction in this study. Understanding how these factors impact response to treatment may improve care disparities among PwCF.
RESULTS: NCT04469439.
METHODS: In a prospective, multi-institutional study, adult PwCF completed the 22-Question SinoNasal Outcome Test (SNOT-22), Smell Identification Test (SIT), Questionnaire of Olfactory Disorder Negative Statements (QOD-NS), and Cystic Fibrosis Questionnaire-Revised (CFQ-R). Lund-Kennedy scores, sinus computed tomography, and clinical data were collected. Data were analyzed across race/ethnicity, sex, and socioeconomic factors using multivariate regression.
RESULTS: Seventy-three PwCF participated with a mean age of 34.7 ± 10.9 years and 49 (67.1%) were female. Linear regression identified that elexacaftor/tezacaftor/ivacaftor (ETI) use (β = ‒4.09, 95% confidence interval [CI] [‒6.08, ‒2.11], p < 0.001), female sex (β = ‒2.14, 95% CI [‒4.11, ‒0.17], p = 0.034), and increasing age (β = ‒0.14, 95% CI [‒0.22, ‒0.05], p = 0.003) were associated with lower/better endoscopy scores. Private health insurance (β = 17.76, 95% CI [5.20, 30.32], p = 0.006) and >16 educational years (β = 13.50, 95% CI [2.21, 24.80], p = 0.020) were associated with higher baseline percent predicted forced expiratory volume in one second (ppFEV1). Medicaid/Medicare insurance was associated with worse endoscopy scores, CFQ-R respiratory scores, and ppFEV1 (all p < 0.017), and Hispanic/Latino ethnicity was associated with worse SNOT-22 scores (p = 0.047), prior to adjustment for other cofactors. No other SDS factors were associated with SNOT-22, QOD-NS, or SIT scores.
CONCLUSIONS: Differences in objective measures of CRS severity exist among PwCF related to sex, age, and ETI use. Variant status and race did not influence patient-reported CRS severity measures or olfaction in this study. Understanding how these factors impact response to treatment may improve care disparities among PwCF.
RESULTS: NCT04469439.
摘要：
背景：社会人口状况（SDS），包括种族/民族和社会经济状况，收入,和保险状况影响囊性纤维化（PwCF）患者的肺部疾病。SDS与慢性鼻窦炎（CRS）之间的关系仍未得到充分研究。
方法：在前瞻性中，多机构研究，成人PwCF完成了22个问题的鼻窦结果测试（SNOT-22），气味识别测试(SIT),嗅觉障碍负面陈述问卷（QOD-NS），和囊性纤维化问卷修订（CFQ-R）。Lund-Kennedy得分,鼻窦计算机断层扫描,收集临床资料。跨种族/族裔分析数据，性别,和社会经济因素使用多元回归。
结果：参加了73例PwCF，平均年龄为34.7±10.9岁，女性为49例（67.1％）。线性回归确定elexacaftor/tezacaftor/ivacaftor（ETI）使用（β=-4.09，95％置信区间[CI][-6.08，-2.11]，p<0.001)，女性(β=-2.14，95%CI[-4.11，-0.17]，p=0.034),年龄增加（β=-0.14，95%CI[-0.22，-0.05]，p=0.003）与较低/较好的内窥镜检查评分相关。私人医疗保险(β=17.76，95%CI[5.20，30.32]，p=0.006)和>16个教育年限(β=13.50，95%CI[2.21，24.80]，p=0.020）与较高的基线百分比在一秒内预测用力呼气量（ppFEV1）相关。Medicaid/Medicare保险与内窥镜检查评分较差有关，CFQ-R呼吸评分,和ppFEV1（所有p<0.017），西班牙裔/拉丁裔种族与更差的SNOT-22得分相关（p=0.047），在调整其他辅因子之前。无其他SDS因子与SNOT-22、QOD-NS、或SIT得分。
结论：与性别相关的PwCF在CRS严重程度的客观测量方面存在差异，年龄,和ETI使用。在这项研究中，变异状态和种族不影响患者报告的CRS严重程度或嗅觉。了解这些因素如何影响对治疗的反应可能会改善PwCF之间的护理差异。
结果：NCT04469439。
方法：在前瞻性中，多机构研究，成人PwCF完成了22个问题的鼻窦结果测试（SNOT-22），气味识别测试(SIT),嗅觉障碍负面陈述问卷（QOD-NS），和囊性纤维化问卷修订（CFQ-R）。Lund-Kennedy得分,鼻窦计算机断层扫描,收集临床资料。跨种族/族裔分析数据，性别,和社会经济因素使用多元回归。
结果：参加了73例PwCF，平均年龄为34.7±10.9岁，女性为49例（67.1％）。线性回归确定elexacaftor/tezacaftor/ivacaftor（ETI）使用（β=-4.09，95％置信区间[CI][-6.08，-2.11]，p<0.001)，女性(β=-2.14，95%CI[-4.11，-0.17]，p=0.034),年龄增加（β=-0.14，95%CI[-0.22，-0.05]，p=0.003）与较低/较好的内窥镜检查评分相关。私人医疗保险(β=17.76，95%CI[5.20，30.32]，p=0.006)和>16个教育年限(β=13.50，95%CI[2.21，24.80]，p=0.020）与较高的基线百分比在一秒内预测用力呼气量（ppFEV1）相关。Medicaid/Medicare保险与内窥镜检查评分较差有关，CFQ-R呼吸评分,和ppFEV1（所有p<0.017），西班牙裔/拉丁裔种族与更差的SNOT-22得分相关（p=0.047），在调整其他辅因子之前。无其他SDS因子与SNOT-22、QOD-NS、或SIT得分。
结论：与性别相关的PwCF在CRS严重程度的客观测量方面存在差异，年龄,和ETI使用。在这项研究中，变异状态和种族不影响患者报告的CRS严重程度或嗅觉。了解这些因素如何影响对治疗的反应可能会改善PwCF之间的护理差异。
结果：NCT04469439。
