(1242) Impact of Updated Referral Guidelines on Primary Care Referrals for Chronic Rhinosinusitis

Introduction: Chronic rhinosinusitis (CRS) affects approximately 11.6% of U.S. adults and is associated with significant morbidity and healthcare utilization. Primary care providers are often the first point of contact, and referral to otolaryngology is guided by evolving clinical guidelines. While recent AAO-HNS recommendations emphasize objective disease evidence and prior medical management before referral, adherence to these guidelines in clinical practice remains incompletely characterized.

Methods: We are conducting a retrospective chart review of all CRS referrals to the otolaryngology clinic at a large academic medical center from January 1, 2025, to December 31, 2025. Primary analysis will determine the proportion of referrals lacking documentation supporting surgical indications. Secondary analyses will compare characteristics between referrals that do and do not meet surgical criteria, identify predictors of low-yield referrals, and assess resource utilization, including additional visits, imaging, and time to otolaryngologic evaluation.

Results: We anticipate identifying a substantial proportion of referrals that do not meet updated surgical-indication criteria. Patients with non-indicated referrals are expected to disproportionately include those with mild or nonspecific symptoms, incomplete prior therapy, or no prior otolaryngologic evaluation.

Conclusions: Our findings will highlight gaps between AAO-HNS guideline-based criteria and real-world AAFP referral practices for CRS. This information can guide strategies to optimize referral efficiency, reduce unnecessary specialty visits, and improve access for patients who meet surgical criteria. Implementing guideline-driven referral pathways may enhance patient care, reduce healthcare utilization, and improve overall outcomes in CRS management.