The following is a summary of the “Race and ethnicity define disparate clinical outcomes in chronic rhinosinusitis,” published in the December 2022 issue of Allergy and Clinical Immunology by Konsur, et al.
To compare the results of individuals with chronic rhinosinusitis (CRS) who are African American (AA), Latinx, and nonLatinx White (White). They performed a large prospective cohort study of patients with CRS, assessing and monitoring them for a variety of clinical characteristics both at the time of initial evaluation and during the course of their ongoing treatment for an average of 40 months. At the beginning of treatment, patients took the Sinonasal Outcome Test (SNOT-22), and at the end of treatment, they took the SNOT-22 again to compare their progress to the beginning of treatment.
After controlling for confounding variables such demographics and prevalence of co-morbidities, we compared results between groups using logistic regression. The racial/ethnic breakdown of the 977 CRS patients enrolled was as follows: 615 (63.1%) White, 235 (24.1%) AA, and 138 (13.1%) Latinx. The Lund-MacKay scores, SNOT-22 scores, and the incidence of concomitant comorbidities at presentation did not differ across the 3 groups for CRS severity. African Americans and Latinx were assessed by an allergist at a lower rate than Whites during the follow-up period.
Overall, AAs scored lower on the SNOT-22 and had fewer CRS-related visits than Whites.
Patients from all 3 groups were similar at baseline in terms of clinical features and illness burden, but after 40 months of follow-up, African Americans fared worse on the SNOT-22 and had fewer visits. Inequity in healthcare access, as shown by inequalities in insurance and inefficient management of CRS, is likely to blame for the observed lower results in AAs.