Affiliation:
1. Department of Head and Neck Surgery University of California Los Angeles California USA
2. Department of Otolaryngology—Head and Neck Surgery Oregon Health Sciences University Portland Oregon USA
3. CTSI David Geffen School of Medicine University of California Los Angeles California USA
4. Department of Otolaryngology—Head and Neck Surgery University of Utah Salt Lake City Utah USA
5. Department of Psychology Portland State University Portland Oregon USA
6. Department of Otolaryngology—Head and Neck Surgery Vanderbilt University Medical Center Nashville Tennessee USA
7. Department of Pulmonary Medicine University of California Los Angeles California USA
8. Department of Otolaryngology—Head and Neck Surgery University of Colorado Denver Colorado USA
9. Department of Otolaryngology—Head and Neck Surgery Stanford University Stanford California USA
10. Department of Otolaryngology—Head and Neck Surgery University of North Carolina Chapel Hill North Carolina USA
11. Department of Medicine National Jewish Health Denver Colorado USA
12. Department of Otolaryngology—Head and Neck Surgery Medical University of South Carolina Charleston South Carolina USA
13. Department of Pediatrics National Jewish Health Denver Colorado USA
Abstract
AbstractBackgroundSociodemographic 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.MethodsIn 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.ResultsSeventy‐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.ConclusionsDifferences 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.Clinical TrialsNCT04469439
Funder
Cystic Fibrosis Foundation