Association of Social Determinants of Health with Time to Diagnosis and Treatment Outcomes in Idiopathic Subglottic Stenosis

被引：6

作者：

Lee, Jaclyn ^{[1
]}

Huang, Li-Ching ^{[2
]}

Berry, Lynn D. ^{[2
]}

Anderson, Catherine ^{[3
]}

Amin, Milan R. ^{[4
]}

Benninger, Michael S. ^{[5
]}

Blumin, Joel H. ^{[6
]}

Bock, Jonathan M. ^{[6
]}

Bryson, Paul C. ^{[5
]}

Castellanos, Paul F. ^{[7
]}

Chen, Sheau-Chiann ^{[2
]}

Clary, Matthew S. ^{[8
]}

Cohen, Seth M. ^{[9
]}

Crawley, Brianna K. ^{[10
]}

Dailey, Seth H. ^{[10
]}

Daniero, James J. ^{[11
]}

De. Alarcon, Alessandro ^{[12
]}

Donovan, Donald T. ^{[13
]}

Edell, Eric S. ^{[14
]}

Ekbom, Dale C. ^{[15
]}

Fink, Daniel S. ^{[8
]}

Franco, Ramon A. ^{[16
]}

Garrett, C. Gaelyn ^{[1
]}

Guardiani, Elizabeth A. ^{[17
]}

Hillel, Alexander T. ^{[18
]}

Hoffman, Henry T. ^{[19
]}

Hogikyan, Norman D. ^{[20
]}

Howell, Rebecca J. ^{[12
]}

Hussain, Lena K. ^{[2
]}

Johns, Michael M. ^{[21
]}

Kasperbauer, Jan L. ^{[15
]}

Khosla, Sid M. ^{[12
]}

Kinnard, Cheryl ^{[2
]}

Kupfer, Robbi A. ^{[20
]}

Langerman, Alexander J. ^{[2
]}

Lentz, Robert J. ^{[2
]}

Lorenz, Robert R. ^{[6
]}

Lott, David G. ^{[22
]}

Lowery, Anne S. ^{[1
]}

Makani, Samir S. ^{[23
]}

Maldonado, Fabien ^{[1
]}

Mannion, Kyle ^{[1
]}

Matrka, Laura ^{[24
]}

McWhorter, Andrew J. ^{[25
]}

Merati, Albert L. ^{[26
]}

Mori, Matthew ^{[27
]}

Netterville, James L. ^{[1
]}

O'Dell, Karla ^{[21
]}

Ongkasuwan, Julina ^{[13
]}

Postma, Gregory N. ^{[28
]}

机构：

[1] Vanderbilt Univ, Med Ctr, Dept Otolaryngol Head & Neck Surg, 1215 21st Ave South,Suite 7302, Nashville, TN 37232 USA

[2] Vanderbilt Ingram Canc Ctr, Vanderbilt Ctr Quantitat Sci, Nashville, TN USA

[3] Australian Market & Social Res Soc, Glebe, NSW, Australia

[4] NYU, Sch Med, Dept Otolaryngol Head & Neck Surg, NYU Voice Ctr, New York, NY USA

[5] Cleveland Clin, Dept Otolaryngol Head & Neck Surg, Head & Neck Inst, Cleveland, OH 44106 USA

[6] Med Coll Wisconsin, Dept Otolaryngol & Commun Sci, Div Laryngol & Profess Voice, Milwaukee, WI 53226 USA

[7] Univ Alabama Birmingham, Dept Surg, Div Otolaryngol, Birmingham, AL 35294 USA

[8] Univ Colorado, Sch Med, Dept Otolaryngol Head & Neck Surg, Denver, CO USA

[9] Duke Univ, Med Ctr, Div Otolaryngol Head & Neck Surg, Duke Voice Care Ctr, Durham, NC USA

[10] Loma Linda Univ Hlth, Dept Otolaryngol Head & Neck Surg, Loma Linda, CA USA

[11] Univ Virginia Hlth Syst, Dept Otolaryngol Head & Neck Surg, Charlottesville, VA USA

[12] Univ Cincinnati, Dept Otolaryngol Head & Neck Surg, Cincinnati, OH USA

[13] Baylor Coll Med, Dept Otolaryngol Head & Neck Surg, Houston, TX 77030 USA

[14] Mayo Clin, Div Pulm & Crit Care Med, Rochester, MN USA

[15] Mayo Clin, Dept Otolaryngol, Coll Med & Sci, Rochester, MN USA

[16] Massachusetts Eye & Ear Infirm, Dept Otolaryngol Head & Neck Surg, Boston, MA 02114 USA

[17] Univ Maryland, Sch Med, Dept Otolaryngol Head & Neck Surg, Baltimore, MD 21201 USA

[18] Johns Hopkins Med Inst, Dept Otolaryngol Head & Neck Surg, Baltimore, MD 21205 USA

[19] Univ Iowa Hosp & Clin, Dept Otolaryngol Head & Neck Surg, Iowa City, IA 52242 USA

[20] Univ Michigan, Med Ctr, Dept Otolaryngol Head & Neck Surg, Ann Arbor, MI 48109 USA

[21] Univ Southern Calif, Dept Otolaryngol Head & Neck Surg, Los Angeles, CA 90007 USA

[22] Mayo Clin Scottsdale, Dept Otorhinolaryngol, Scottsdale, AZ USA

[23] Univ Calif San Diego, Div Pulm & Crit Care Med, San Diego, CA 92103 USA

[24] Ohio State Univ, Med Ctr, Dept Otolaryngol Head & Neck Surg, Columbus, OH 43210 USA

[25] Louisiana State Univ, Dept Otolaryngol, Hlth Sci Ctr New Orleans, New Orleans, LA USA

[26] Univ Washington, Med Ctr, Dept Otolaryngol Head & Neck Surg, Seattle, WA 98195 USA

[27] New York Eye & Ear Infirm Mt Sinai, Dept Otolaryngol, New York, NY USA

[28] Augusta Univ, Med Coll Georgia, Dept Otolaryngol Head & Neck Surg, Augusta, GA USA

[29] Bastian Voice Inst, Downers Grove, IL USA

[30] Vanderbilt Univ, Med Ctr, Div Allergy Pulm & Crit Care Med, Nashville, TN USA

[31] Univ Calif San Francisco, Dept Otolaryngol Head & Neck Surg, San Francisco, CA 94143 USA

[32] Imperial Coll Healthcare NHS Trust, Charing Cross Hosp, Natl Ctr Airway Reconstruct, London, England

[33] Oregon Hlth & Sci Univ, Dept Otolaryngol Head & Neck Surg, Northwest Clin Voice & Swallowing, Portland, OR 97201 USA

[34] Univ Rochester, Dept Otolaryngol, Rochester, NY USA

[35] Univ N Carolina, Dept Otolaryngol Head & Neck Surg, Chapel Hill, NC 27515 USA

[36] Univ Utah, Div Otolaryngol Head & Neck Surg, Salt Lake City, UT USA

[37] Univ Pittsburgh, Dept Otolaryngol Head & Neck Surg, Pittsburgh, PA USA

[38] Temple Univ, Dept Otolaryngol Head & Neck Surg, Lewis Katz Sch Med, Philadelphia, PA 19122 USA

[39] Landspitali Univ Hosp, Reykjavik, Iceland

[40] Royal North Shore Hosp, Dept Otolaryngol Head & Neck Surg, Sydney, NSW, Australia

[41] Univ Calif Irvine, Dept Otolaryngol Head & Neck Surg, Irvine, CA USA

[42] LSU Shreveport, Feist Weiller Canc Ctr, Dept Otolaryngol, Shreveport, LA USA

[43] LSU Shreveport, Feist Weiller Canc Ctr, Dept Mol & Cellular Physiol, Shreveport, LA USA

[44] Univ Calif San Diego, Dept Surg, Div Otolaryngol Head & Neck Surg, San Diego, CA 92103 USA

[45] Univ Wisconsin, Div Otolaryngol Head & Neck Surg, Madison, WI USA

来源：

ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY | 2021年 / 130卷 / 10期

关键词：

income; education; social support; iSGS; time to diagnosis; surgical outcomes; SUPPORT; RACE;

D O I：

10.1177/0003489421995283

中图分类号：

R76 [耳鼻咽喉科学];

学科分类号：

100213 ;

摘要：

Objectives: To examine whether social determinants of health (SDH) factors are associated with time to diagnosis, treatment selection, and time to recurrent surgical intervention in idiopathic subglottic stenosis (iSGS) patients. Methods: Adult patients with diagnosed iSGS were recruited prospectively (2015-2017) via clinical providers as part of the North American Airway Collaborative (NoAAC) and via an online iSGS support community on Facebook. Patient-specific SDH factors included highest educational attainment (self-reported), median household income (matched from home zip code via U.S. Census data), and number of close friends (self-reported) as a measure of social support. Main outcomes of interest were time to disease diagnosis (years from symptom onset), treatment selection (endoscopic dilation [ED] vs cricotracheal resection [CTR] vs endoscopic resection with adjuvant medical therapy [ERMT]), and time to recurrent surgical intervention (number of days from initial surgical procedure) as a surrogate for disease recurrence. Results: The total 810 participants were 98.5% female, 97.2% Caucasian, and had a median age of 50 years (IQR, 43-58). The cohort had a median household income of $62 307 (IQR, $50 345-$79 773), a median of 7 close friends (IQR, 4-10), and 64.7% of patients completed college or graduate school. Education, income, and number of friends were not associated with time to diagnosis via multivariable linear regression modeling. Univariable multinominal logistic regression demonstrated an association between education and income for selecting ED versus ERMT, but no associations were noted for CTR. No associations were noted for time to recurrent surgical procedure via Kaplan Meier modeling and Cox proportional hazards regression. Conclusions: Patient education, income, and social support were not associated with time to diagnosis or time to disease recurrence. This suggests additional patient, procedure, or disease-specific factors contribute to the observed variations in iSGS surgical outcomes.

引用

页码：1116 / 1124

页数：9

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