Chronic rhinosinusitis in children: race and socioeconomic status

David F Smith, Stacey L Ishman, David E Tunkel, Emily F Boss
Otolaryngology—Head and Neck Surgery 2013, 149 (4): 639-44

PURPOSE: Although chronic rhinosinusitis (CRS) is common in children, the influence of race and socioeconomic status (SES) on the diagnosis/treatment of CRS has not been evaluated. We describe the epidemiology of children with CRS in a pediatric otolaryngology clinic and evaluate demographic differences when compared to a group of children referred for a general pediatric otolaryngology evaluation.

STUDY DESIGN: Historical cohort study.

SETTING: Tertiary academic care center.

SUBJECTS AND METHODS: All new/consult patients (March 1, 2008-July 1, 2011) in a tertiary pediatric otolaryngology clinic with primary diagnosis of CRS were compared to a control group that consisted of all new/consult patients seen in the same clinic over 3 months. Records were evaluated for variables including age, sex, race, and insurance. Characteristics were compared between groups using Mann-Whitney and Fisher's exact tests.

RESULTS: One hundred and seventy-four children with CRS were compared to 430 controls. When compared to the general pediatric otolaryngology population, children with CRS were older (8.2 ± 4.4 years vs 5.9 ± 4.8 years; P < .0001) and more commonly male (63% vs 52%; P = .018). When compared to controls, children with CRS were more likely to be white (CRS 77% white, 10% black, 13% other vs control 47% white, 33% black, 20% other; P < .0001, risk ratio [RR] = 2.7; 95% confidence interval [CI], 2.0-3.7). Likewise, children with CRS were less commonly insured with medical assistance (CRS 14% vs control 44%; P < .0001; RR = 0.3; 95% CI, 0.21-0.45).

CONCLUSIONS: When compared to the general population of children seen in this academic urban pediatric otolaryngology setting, children with CRS were more likely to be white and privately insured. This study is the first to evaluate race and SES in relationship to pediatric CRS. Future research should employ nationally representative data to assess the true demographic variation in children with CRS.

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