Your browser doesn't support javascript.
loading
Association of Social Determinants of Health with Time to Diagnosis and Treatment Outcomes in Idiopathic Subglottic Stenosis.
Lee, Jaclyn; Huang, Li-Ching; Berry, Lynn D; Anderson, Catherine; Amin, Milan R; Benninger, Michael S; Blumin, Joel H; Bock, Jonathan M; Bryson, Paul C; Castellanos, Paul F; Chen, Sheau-Chiann; Clary, Matthew S; Cohen, Seth M; Crawley, Brianna K; Dailey, Seth H; Daniero, James J; de Alarcon, Alessandro; Donovan, Donald T; Edell, Eric S; Ekbom, Dale C; Fink, Daniel S; Franco, Ramon A; Garrett, C Gaelyn; Guardiani, Elizabeth A; Hillel, Alexander T; Hoffman, Henry T; Hogikyan, Norman D; Howell, Rebecca J; Hussain, Lena K; Johns, Michael M; Kasperbauer, Jan L; Khosla, Sid M; Kinnard, Cheryl; Kupfer, Robbi A; Langerman, Alexander J; Lentz, Robert J; Lorenz, Robert R; Lott, David G; Lowery, Anne S; Makani, Samir S; Maldonado, Fabien; Mannion, Kyle; Matrka, Laura; McWhorter, Andrew J; Merati, Albert L; Mori, Matthew; Netterville, James L; O'Dell, Karla; Ongkasuwan, Julina; Postma, Gregory N.
Afiliação
  • Lee J; Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, TN, USA.
  • Huang LC; Vanderbilt Center for Quantitative Sciences, Vanderbilt-Ingram Cancer Center, Nashville, TN, USA.
  • Berry LD; Vanderbilt Center for Quantitative Sciences, Vanderbilt-Ingram Cancer Center, Nashville, TN, USA.
  • Anderson C; Australian Market and Social Research Society, Glebe, NSW, Australia.
  • Amin MR; NYU Voice Center, Department of Otolaryngology-Head and Neck Surgery, New York University School of Medicine, New York, NY, USA.
  • Benninger MS; Department of Otolaryngology-Head and Neck Surgery, Head and Neck Institute, Cleveland Clinic, Cleveland, OH, USA.
  • Blumin JH; Division of Laryngology and Professional Voice, Department of Otolaryngology and Communication Sciences, Medical College of Wisconsin, Milwaukee, WI, USA.
  • Bock JM; Division of Laryngology and Professional Voice, Department of Otolaryngology and Communication Sciences, Medical College of Wisconsin, Milwaukee, WI, USA.
  • Bryson PC; Department of Otolaryngology-Head and Neck Surgery, Head and Neck Institute, Cleveland Clinic, Cleveland, OH, USA.
  • Castellanos PF; Division of Otolaryngology, Department of Surgery, University of Alabama at Birmingham, Birmingham, AL, USA.
  • Chen SC; Vanderbilt Center for Quantitative Sciences, Vanderbilt-Ingram Cancer Center, Nashville, TN, USA.
  • Clary MS; Department of Otolaryngology-Head and Neck Surgery, University of Colorado School of Medicine, Denver, CO, USA.
  • Cohen SM; Duke Voice Care Center, Division of Otolaryngology-Head and Neck Surgery, Duke University Medical Center, Durham, NC, USA.
  • Crawley BK; Department of Otolaryngology-Head and Neck Surgery, Loma Linda University Health, Loma Linda, CA, USA.
  • Dailey SH; Department of Otolaryngology-Head and Neck Surgery, Loma Linda University Health, Loma Linda, CA, USA.
  • Daniero JJ; Department of Otolaryngology-Head and Neck Surgery, University of Virginia Health System, Charlottesville, VA, USA.
  • de Alarcon A; Department of Otolaryngology-Head and Neck Surgery, University of Cincinnati, Cincinnati, OH, USA.
  • Donovan DT; Department of Otolaryngology-Head and Neck Surgery, Baylor College of Medicine, Houston, TX, USA.
  • Edell ES; Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN, USA.
  • Ekbom DC; Department of Otolaryngology, Mayo Clinic College of Medicine and Science, Rochester, MN, USA.
  • Fink DS; Department of Otolaryngology-Head and Neck Surgery, University of Colorado School of Medicine, Denver, CO, USA.
  • Franco RA; Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear Infirmary, Boston, MA, USA.
  • Garrett CG; Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, TN, USA.
  • Guardiani EA; Department of Otorhinolaryngology-Head and Neck Surgery, University of Maryland School of Medicine, Baltimore, MD, USA.
  • Hillel AT; Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins Medical Institution, Baltimore, MD, USA.
  • Hoffman HT; Department of Otolaryngology-Head and Neck Surgery, University of Iowa Hospitals and Clinics, Iowa City, IA, USA.
  • Hogikyan ND; Department of Otolaryngology-Head and Neck Surgery, University of Michigan Medical Center, Ann Arbor, MI, USA.
  • Howell RJ; Department of Otolaryngology-Head and Neck Surgery, University of Cincinnati, Cincinnati, OH, USA.
  • Hussain LK; Vanderbilt Center for Quantitative Sciences, Vanderbilt-Ingram Cancer Center, Nashville, TN, USA.
  • Johns MM; Department of Otolaryngology-Head and Neck Surgery, University of Southern California, Los Angeles, CA, USA.
  • Kasperbauer JL; Department of Otolaryngology, Mayo Clinic College of Medicine and Science, Rochester, MN, USA.
  • Khosla SM; Department of Otolaryngology-Head and Neck Surgery, University of Cincinnati, Cincinnati, OH, USA.
  • Kinnard C; Vanderbilt Center for Quantitative Sciences, Vanderbilt-Ingram Cancer Center, Nashville, TN, USA.
  • Kupfer RA; Department of Otolaryngology-Head and Neck Surgery, University of Michigan Medical Center, Ann Arbor, MI, USA.
  • Langerman AJ; Vanderbilt Center for Quantitative Sciences, Vanderbilt-Ingram Cancer Center, Nashville, TN, USA.
  • Lentz RJ; Vanderbilt Center for Quantitative Sciences, Vanderbilt-Ingram Cancer Center, Nashville, TN, USA.
  • Lorenz RR; Division of Laryngology and Professional Voice, Department of Otolaryngology and Communication Sciences, Medical College of Wisconsin, Milwaukee, WI, USA.
  • Lott DG; Department of Otorhinolaryngology, Mayo Clinic Scottsdale, Scottsdale, AZ, USA.
  • Lowery AS; Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, TN, USA.
  • Makani SS; Division of Pulmonary and Critical Care Medicine, University of California, San Diego, San Diego, CA, USA.
  • Maldonado F; Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, TN, USA.
  • Mannion K; Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, TN, USA.
  • Matrka L; Department of Otolaryngology-Head and Neck Surgery, The Ohio State University Medical Center, Columbus, OH, USA.
  • McWhorter AJ; Department of Otolaryngology, Louisiana State University Health Sciences Center-New Orleans, New Orleans, LA, USA.
  • Merati AL; Department of Otolaryngology-Head and Neck Surgery, University of Washington Medical Center, Seattle, WA, USA.
  • Mori M; Department of Otolaryngology, New York Eye and Ear Infirmary of Mount Sinai, New York, NY USA.
  • Netterville JL; Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, TN, USA.
  • O'Dell K; Department of Otolaryngology-Head and Neck Surgery, University of Southern California, Los Angeles, CA, USA.
  • Ongkasuwan J; Department of Otolaryngology-Head and Neck Surgery, Baylor College of Medicine, Houston, TX, USA.
  • Postma GN; Department of Otolaryngology-Head and Neck Surgery, Medical College of Georgia at Augusta University, Augusta, GA, USA.
Ann Otol Rhinol Laryngol ; 130(10): 1116-1124, 2021 Oct.
Article em En | MEDLINE | ID: mdl-33629608
ABSTRACT

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.
Assuntos
Palavras-chave
Texto completo
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Laringoestenose / Determinantes Sociais da Saúde / Laringoscopia Idioma: En Ano de publicação: 2021 Tipo de documento: Article
Texto completo
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Laringoestenose / Determinantes Sociais da Saúde / Laringoscopia Idioma: En Ano de publicação: 2021 Tipo de documento: Article