Social Vulnerability and Quality of Life in Chronic Rhinosinusitis.

Abstract

Social determinants of health (SDoH) impact surgical outcomes, risk-adjusted prognoses, and overall health. The Social Vulnerability Index (SVI) measures SDoH based on 16 social factors. This study evaluates the impact of social vulnerability on the quality of life of those living with chronic rhinosinusitis (CRS). A retrospective cohort review of 657 patients at a single institution. CRS patients with cystic fibrosis, nasal obstruction, and nasal cancer were excluded. Baseline covariates, including SNOT-22 scores, sex, and history of surgery, were collected. SVI was calculated using the National Social Vulnerability Index 2020 Database by Census Tract. Statistical analyses were conducted. A lower SVI score was associated with lower SNOT-22 scores, independent of sex, presence of polyps, or history of surgery (p < 0.001). Patients in the "Low to Medium" SVI category were significantly less likely to undergo surgery compared to those in other SVI categories (p = 0.04). Compared to patients with CRSwNP, those with CRSsNP had significantly worse SNOT-22 scores (p = 0.038) but no significant difference in SVI scores. Surgery was performed in 69% of patients with CRSsNP and 84% of those with CRSwNP. Social vulnerability impacts the likelihood of surgery and quality of life in patients with CRS. Higher vulnerability is associated with worse sinonasal symptoms, regardless of confounders. CRS patients with lower social vulnerability are less likely to have surgery. SNOT-22 scores did not influence the likelihood of surgery.