Abstract
Rhinosinusitis is a common condition with adults experiencing 2–5 episodes per year. The European Positional Paper on Rhinosinusitis and Nasal Polyps (EP3OS) published in 2005 and updated in 2007 provided evidence-based guidelines on the management of sinus disease promoting a conservative approach to treatment. This study examines the effect of EP3OS on sinus surgery uptake and acute admissions for sinusitis in England and Wales. A retrospective study using the national electronic health databases of England (Hospital Episodes Statistics, HES online) and Wales (Patient Episodes Database of Wales, PEDW) was undertaken from 2000 to 2010 using the OPCS-4 codes E12–E17 (sinus surgery) and ICD10 code J01 (acute admission for sinusitis). Data were analysed for effect following the introduction of the EP3OS in 2005 using linear regression and Chi squared analysis. 116,370 sinus procedures and 10,916 acute admissions for sinusitis were made during the study period. No significant decrease in sinus surgery procedures occurred following the introduction of the EP3OS as may have been expected (p > 0.05), although subgroup analysis suggested a significant increase in Wales (p < 0.05). In addition, significant increases in acute admissions for sinusitis were observed following the introduction of EP3OS (p < 0.05). However, subgroup analysis suggested this was not the case in Wales (p > 0.05). The EP3OS appears to have had little impact on the rates of sinus surgery but more conservative approaches to managing of sinus disease may have led to an increase in acute admissions. Further research is required to investigate whether changes in practice were adopted.
Similar content being viewed by others
References
Johnston S, Holgate S (1996) Epidemiology of viral respiratory tract infections. In: Myint S, Taylor-Robinson D (eds) Viral and other infections of the human respiratory tract. Chapman & Hall, London, pp 1–38
Ray NF, Baraniuk JN, Thamer M, Rinehart CS, Gergen PJ, Kaliner M, Josephs S, Pung YH (1999) Healthcare expenditures for sinusitis in 1996: contributions of asthma, rhinitis, and other airway disorders. J Allergy Clinic Immunol 103(3):408–414
Fokkens W, Lund V, Mullol J (2007) on behalf of the European Position Paper on Rhinosinusitis and Nasal Polyps group. EP3OS 2007: European position paper on rhinosinusitis and nasal polyps 2007. Rhinology 45:97–101
Blackwell D, Coles R (2002) National Center for Health Statistics. Summary health statistics for US adults: National Health Interview Survey 1997. Vital Health Stat 10(205):15
Collins JG (1997) Prevalence of selected chronic conditions: United States, 1990–1992. Vital and health statistics Series 10, Data from the National Health Survey (194):1
Gliklich RE, Metson R (1995) The health impact of chronic sinusitis in patients seeking otolaryngologic care. Otolaryngol-Head Neck Surg 113(1):104–109
Fokkens W, Lund V, Bachert C, Clement P, Helllings P, Holmstrom M, Jones N, Kalogjera L, Kennedy D, Kowalski M (2005) European position paper on rhinosinusitis and nasal polyps. Rhinology:1–87
Hopkins C, Browne JP, Slack R, Lund VJ, Topham J, Reeves BC, Copley LP, Brown P, van der Meulen JHP (2006) Complications of surgery for nasal polyposis and chronic rhinosinusitis: The results of a national audit in England and Wales. Laryngoscope 116(8):1494–1499
Office for National Statistics (2010) Population estimates for UK, England and Wales, Scotland and Northern Ireland, current datasets. http://www.statistics.gov.uk/statbase/product.asp?vlnk=15106. Accessed 18 January 2011
Evans L, Owens D, Backhouse S (2011) Hospital at Night (H@N) and ENT. Has workforce transformation effected hospital admission rate, appropriate admission rate and duration of hospital stay? Paper presented at the ENT UK annual conference, Royal College of Surgeons, London., 9/9/2011
Conflict of interest
The authors have no conflicts of interest to declare.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Cosway, B., Tomkinson, A. & Owens, D. The European positional paper on rhinosinusitis and nasal polyps: has the introduction of guidance on the management of sinus disease affected uptake of surgery and acute admissions for sinusitis?. Eur Arch Otorhinolaryngol 270, 889–892 (2013). https://doi.org/10.1007/s00405-012-2027-2
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00405-012-2027-2