Inpatient Mortality After Endoscopic Sinus Surgery for Invasive Fungal Rhinosinusitis.
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| Title: | Inpatient Mortality After Endoscopic Sinus Surgery for Invasive Fungal Rhinosinusitis. |
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| Authors: | Burton, Brittany N., Jafari, Aria, Asmerom, Betial, Swisher, Matthew W., Gabriel, Rodney A., DeConde, Adam |
| Source: | Annals of Otology, Rhinology & Laryngology. Apr2019, Vol. 128 Issue 4, p300-308. 9p. |
| Subjects: | Confidence intervals, Endoscopy, Nosology, Sinusitis, Multiple regression analysis, Treatment effectiveness, Descriptive statistics, Hospital mortality, Odds ratio, Disease complications |
| Abstract: | Objectives: Invasive fungal rhinosinusitis is a rare, life-threatening condition that affects the paranasal sinuses. The standard of care after diagnosis includes surgical debridement and aggressive medical management. Despite treatment, mortality remains unacceptably high. Most data are derived from small cohort experiences, with limited identification of mortality risk factors in the acute setting. The authors used a large national database to better understand clinical factors associated with inpatient mortality for this challenging condition. Methods: Using the 2000-2014 National (Nationwide) Inpatient Sample database, the authors identified 979 adult patients with an International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis code of mucormycosis or aspergillosis and a procedure code of sinus surgery. Multivariate imputation by chained equation was performed to account for missing data, followed by multivariate logistic regression to identify predictors of inpatient mortality. Results: In total, 979 adult patients were identified, with a median age of 57 years. The inpatient mortality rate was 15.8%. The most prevalent comorbidity was hematologic disorders (42.9%). Mucormycosis versus aspergillosis was associated with increased odds of inpatient mortality (odds ratio, 2.95; 95% confidence interval, 2.00-4.34; P < .001). The odds of inpatient mortality were significantly increased between patients with hematologic disorders and those without (odds ratio, 1.92; 95% confidence interval, 1.08-3.39; P = .024). Diabetes (odds ratio, 0.53; 95% confidence interval, 0.34 − 0.80; P = .003) was associated with the lowest odds of inpatient mortality. Conclusions: This represents the first population-based study evaluating the factors associated with inpatient mortality. These findings support prior observations demonstrating that the underlying immune dysfunction and type of fungal infection are important predictors of early mortality. [ABSTRACT FROM AUTHOR] |
| Copyright of Annals of Otology, Rhinology & Laryngology is the property of Sage Publications Inc. and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.) | |
| Database: | Psychology and Behavioral Sciences Collection |
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