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Management of non-invasive rhinosinusitis in the immunosuppressed patient population
Management of non-invasive rhinosinusitis in the immunosuppressed patient population LARYNGOSCOPE Dao, A. M., Rereddy, S. K., Wise, S. K., DelGaudio, J. M., Patel, Z. M. 2015; 125 (8): 1767-1771Abstract
Rhinologists are seeing an increasing number of immunosuppressed patients. Currently, no treatment paradigm exists for treating acute and chronic noninvasive rhinosinusitis (ARS, CRS) in this growing population. This study aims to identify patient and treatment factors that affect rhinosinusitis outcomes in this vulnerable population.Prognostic retrospective cohort study.Immunocompromised patients treated by rhinologists for ARS or CRS 10/2007 to 10/2012 were identified by rhinosinusitis diagnostic codes, codes for transplant, cancer, HIV, diabetes, and codes indicating immunosuppression in the intensive care setting. Associations between patient factors and outcome were analyzed by logistic regression. Associations between treatment and outcome were analyzed by Firth logistic regression.A total of 132 subjects were identified. Of those, 90.9% had CRS and 9.1% had ARS; 12.9% were transplant patients; 47% were diabetic; 37.9% were cancer patients; and 16.7% were in the intensive care unit. Patients with higher American Society of Anesthesiologists (ASA) scores had decreased disease resolution (odds ratio [OR]?=?0.5, P?=?0.021). Transplant patients (OR?=?22.5, P?=?0.001), diabetics patients (OR?=?6.4, P?=?0.017), cancer patients (OR?=?5.4, P?=?0.046), and patients with prior medical therapy for rhinosinusitis (OR?=?5.84, P?
View details for DOI 10.1002/lary.25305
View details for Web of Science ID 000358379700012
View details for PubMedID 25946593