Mahboobeh Mahdavinia1, Mohamed Benhammuda2, Christopher D Codispoti2, Mary C Tobin2, Philip S Losavio3, Arpita Mehta2, Jill S Jeffe3, Sindhura Bandi2, Anju T Peters4, Whitney W Stevens4, Alan Landay2, Ali Keshavarzian4, Robert P Schleimer5, Pete S Batra3. 1. Allergy/Immunology Section, Department of Immunology and Microbiology, Rush University Medical Center, Chicago, Ill. Electronic address: Mahboobeh_mahdavinia@rush.edu. 2. Allergy/Immunology Section, Department of Immunology and Microbiology, Rush University Medical Center, Chicago, Ill. 3. Department of Otorhinolaryngology-Head and Neck Surgery, Rush University Medical Center, Chicago, Ill. 4. Division of Gastroenterology, Internal Medicine Department, Rush University Medical Center, Chicago, Ill. 5. Division of Allergy-Immunology, Internal Medicine Department, Northwestern University Feinberg School of Medicine, Chicago, Ill. Electronic address: rpschleimer@northwestern.edu.
Abstract
BACKGROUND: Chronic rhinosinusitis (CRS) is a common inflammatory disease of the upper airways that is often categorized into subtypes including "with" and "without" nasal polyps. However, the influence of multiple important epidemiologic factors, including race, on CRS has not been investigated. OBJECTIVE: The present study assessed various phenotypic characteristics of CRS in patients, living in the United States, with different racial backgrounds. METHODS: We performed a large retrospective cohort study of patients with CRS treated at a large urban tertiary care referral center in Chicago. RESULTS: African American (AA) patients with CRS living in Chicago were more likely to report hyposmia as a symptom of CRS. Furthermore, AA patients with CRS who failed medical therapy and required surgical intervention had a significantly higher frequency of nasal polyposis and aspirin-exacerbated respiratory disease, and a higher disease severity index on computed tomography imaging than did white patients with CRS. The increased polyposis in AAs was associated with increased hospitalization for asthma. There were no differences in the prevalence of atopy, asthma, atopic dermatitis, food allergy, duration of disease, or number of surgeries between different races. CONCLUSIONS: AAs with refractory CRS are at increased risk for nasal polyposis, smell loss, aspirin-exacerbated respiratory disease, and a greater severity of disease based on imaging, resulting in increased health care utilization.
BACKGROUND:Chronic rhinosinusitis (CRS) is a common inflammatory disease of the upper airways that is often categorized into subtypes including "with" and "without" nasal polyps. However, the influence of multiple important epidemiologic factors, including race, on CRS has not been investigated. OBJECTIVE: The present study assessed various phenotypic characteristics of CRS in patients, living in the United States, with different racial backgrounds. METHODS: We performed a large retrospective cohort study of patients with CRS treated at a large urban tertiary care referral center in Chicago. RESULTS: African American (AA) patients with CRS living in Chicago were more likely to report hyposmia as a symptom of CRS. Furthermore, AA patients with CRS who failed medical therapy and required surgical intervention had a significantly higher frequency of nasal polyposis and aspirin-exacerbated respiratory disease, and a higher disease severity index on computed tomography imaging than did white patients with CRS. The increased polyposis in AAs was associated with increased hospitalization for asthma. There were no differences in the prevalence of atopy, asthma, atopic dermatitis, food allergy, duration of disease, or number of surgeries between different races. CONCLUSIONS: AAs with refractory CRS are at increased risk for nasal polyposis, smell loss, aspirin-exacerbated respiratory disease, and a greater severity of disease based on imaging, resulting in increased health care utilization.
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