Prevalence of chronic rhinosinusitis with nasal polyps higher in urban residents and the elderly

In Poland, the prevalence of chronic rhinosinusitis with nasal polyps was found to be higher in men, the elderly and people living in urban areas.

A greater prevalence of chronic rhinosinusitis with nasal polyps (CRSwNP) in the Polish population was associated with male gender, older age, and living in urban areas, in which inpatient services accounted for the majority of the total cost of the disease. The findings were reported by Advances in Dermatology and Allergology.

Typically affecting middle-aged and elderly patients, the average age at diagnosis of CRSwNP is 40–60 years, and male gender and incidence of eosinophilic inflammation have been cited as risk factors.

Compared to CRS patients without nasal polyps, those with CRSwNP have been associated with more severe disease and a greater comorbidity burden that requires continued long-term drug therapy and regular specialist consultations or surgery. .

“Typical features associated with CRSwNP are chronicity, a tendency to relapse, and a frequent need for glucocorticoid and surgical treatment, generating considerable direct and indirect socioeconomic costs,” the study authors added. “Generally, once diagnosed, CRSwNP is a lifelong condition in most cases.”

They performed a statistical analysis of data on the reported prevalence of CRSwNP in the Polish population, including demographics and comorbidities, as well as the costs of outpatient and inpatient services funded by the National Health Fund (NHF) registers of 2008 to 2018.

Of the 33,876,567 people assessed for the study, the number of patients receiving outpatient or inpatient services related to CRSwNP ranged from 29,900 to 32,500 per year. In 2018, 28,200 patients attended 58,200 outpatient visits for CRSwNP (2.06 per patient) and 4,400 patients had 4,700 hospitalizations (1.06 per patient).

Per 10,000 Polish inhabitants, the recorded prevalence of CRSwNP in 2018 was 52.0 (52%), with males having a higher prevalence than females (64.6/10,000 [0.65%] against 40.2/10,000 [0.40%]). Prevalence was also shown to vary by geographic location, with both men and women reporting a higher incidence if they lived in urban areas compared to rural areas (men: 75.3/10,000 vs. 49 ,1/10,000; women: 46.3/10,000 versus 30.7/10,000).

Additionally, CRSwNP was more common in patients aged 55-59 years (98.1/10,000) and 75-79 years (98.7/10,000). Among males, the highest prevalence was among those aged 75-79 years (164.3/10,000) and among females the prevalence peaked in the age group 55-59 years (75.1 /10,000).

Regarding costs, the Polish NHF spent 17.2 million zł in 2018 (equivalent to 4.7 million US dollars) for health services related to the diagnosis of nasal polyps, with hospitalization services accounting for 77, 4% of the total cost. The highest level of costs per patient was observed in regions where the highest share of hospital services was also observed.

“The NHF data compared with a population-wide epidemiological study show that a large proportion of patients with nasal polyps do not receive regular treatment or even see a doctor,” the authors concluded. ‘study. “Treating patients with nasal polyps is not cost-effective.”

Reference

Raciborski F, Arcimowicz M, Samoliński B, et al. The recorded prevalence of nasal polyps increases with age. Postepy Dermatol Alergol. 2021 Aug;38(4):682-688. doi:10.5114/ada.2020.99365

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