Socioeconomic Status Impacts The Prognosis Of Chronic Rhinosinusitis Treated By Endoscopic Sinus Surgery

Objective:Few studies have explored the association between socioeconomic capacity and postoperative outcomes in patients with chronic sinusitis（CRS）after functional endoscopic sinus surgery（ESS）.Methods:We conducted an observational cohort study of 1,047 patients with CRS undergoing ESS surgery.Successful discharged patients were followed up for up to 72weeks for all-cause recurrence events.Baseline socioeconomic capacity was established based on occupation,education level and family income of the patients in the year before the operation.Kaplan-Meier method was used to calculate the recovery after ESS.Cox proportional hazards regression was used to evaluate the relationship between socioeconomic capacity and prognosis.Results:The median age at surgery was 36（IQR27-46）years.The overall recovery rate at 12 weeks and 24 weeks after surgery was 19.1%and 44.7%,respectively.The overall24-week recovery rate was 90.4%[95%confidence interval（CI）:89.6%-91.2%]in the moderate socioeconomic capacity and 13.5%（95%CI:12.8%-14.2%）in the low socioeconomic capacity.31.7%（95%CI:30.7%-32.7%）in high socioeconomic capacity（all log-rank P<0.001）,and the recurrence rate in the medium socioeconomic capacity was lower than that in the low and high socioeconomic capacity groups.After adjusting for relevant covariates,multivariate COX proportional hazards regression analysis showed that the hazard ratio（HRs）of low socioeconomic capacity versus moderate SES group was 7.69(95%CI:6.17-9.71,P_trend<0.001),and the hazard ratio（HRs）was 6.19(95%CI:4.78-7.93,P_trend<0.001).Conclusions:Low and high socioeconomic capacity is associated with worse prognosis of CRS patients after ESS than middle socioeconomic capacity.We can help patients with low socioeconomic capacity to reduce the burden of medical costs and ensure long-term care after surgery.For patients with high socioeconomic capacity,increasing psychological counseling and improving the high-pressure working environment may have a positive regulatory effect on the prognosis.