Socioeconomic factors in the diagnosis of allergic fungal rhinosinusitis

Abstract

Objectives 1) To investigate socioeconomic and demographic factors differentiating allergic fungal rhinosinusitis (AFRS) from other chronic rhinosinusitis (CRS) diagnostic groups. 2) To consider the potential impact of epidemiological differences on AFRS disease course. Study Design Retrospective review. Study Methods Retrospective review of AFRS patients, CRS patients with nasal polyps (CRSwNP) without AFRS, and CRS patients without polyps (CRSsNP). Analysis of group differences was performed for age at presentation, gender, ethnicity, insurance status, and socioeconomic measures with the use of medical records and a South Carolina demographic database. Results AFRS presentation age was lower than CRSwNP and CRSsNP ( P < 0.001). The AFRS group had more African Americans ( P < 0.001) and uninsured or Medicaid patients ( P < 0.001) than expected. AFRS patients resided in counties with higher poverty percentage ( P = 0.011), lower median income ( P = 0.048), and more African American residents ( P = 0.020) than CRSsNP patients. No group differences existed for gender or physicians per 1000 county residents. Conclusion Demographic and socioeconomic factors may affect AFRS presentation and treatment.