Department of Otorhinolaryngology-Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China.
Beijing Institute of Otolaryngology, Beijing Key Laboratory of Nasal diseases, Beijing, China.
Am J Rhinol Allergy. 2021 Sep;35(5):578-586. doi: 10.1177/1945892420978957. Epub 2020 Dec 6.
The preoperative prediction of the recurrence of chronic rhinosinusitis with nasal polyps (CRSwNP) remains difficult in clinical practice.
We aimed to develop a nomogram that combined peripheral risk factors to clinically predict the recurrence of CRSwNP.
Data from 158 CRSwNP patients who underwent endoscopic sinus surgery (ESS) from January 2012 to December 2016 were collected, and the patients were followed up for 3 years. Of these, 96 patients who underwent ESS in an earlier period formed the training cohort for nomogram development, and 62 patients who underwent ESS thereafter formed the validation cohort to confirm the model's performance. Risk factors for recurrence identified by univariate and multivariate logistic regression were used to create a nomogram.
The recurrence rate was 29.2% (28/96) for the training cohort and 35.5% (22/62) for the validation cohort. Univariate analysis identified blood eosinophils (Eos), serum IgE level, asthma comorbidity, and the number of previous ESSs as risk factors for recurrence. Among those four parameters, serum IgE level and a previous ESS surgery were identified as two independent risk factors. A nomogram consisting of blood Eos, total serum IgE level, asthma comorbidity, and the number of previous ESSs was constructed, demonstrating a C index of 0.81 (95% CI, 0.79-0.83) and 0.80 (95% CI, 0.77-0.83) for predicting recurrence in the training and validation cohorts, respectively. The nomogram had well-fitted calibration curves.
The nomogram might be able to preoperatively predict the recurrence of CRSwNP by using currently available and objective parameters. Further studies are required to validate its reliability and effectiveness.
慢性鼻-鼻窦炎伴鼻息肉（CRSwNP）的术前复发预测在临床实践中仍然具有挑战性。
我们旨在开发一种列线图，该列线图结合外周危险因素，用于临床预测 CRSwNP 的复发。
收集了 158 例于 2012 年 1 月至 2016 年 12 月接受内镜鼻窦手术（ESS）的 CRSwNP 患者的数据，对患者进行了 3 年的随访。其中，96 例早期接受 ESS 的患者形成了列线图开发的训练队列，此后接受 ESS 的 62 例患者形成了验证队列，以确认模型的性能。通过单因素和多因素逻辑回归确定复发的危险因素，用于创建列线图。
训练队列的复发率为 29.2%（28/96），验证队列的复发率为 35.5%（22/62）。单因素分析确定血嗜酸性粒细胞（Eos）、血清 IgE 水平、哮喘合并症和 ESS 次数为复发的危险因素。在这四个参数中，血清 IgE 水平和 ESS 手术被确定为两个独立的危险因素。构建了一个由血嗜酸性粒细胞、总血清 IgE 水平、哮喘合并症和 ESS 次数组成的列线图，在训练和验证队列中，预测复发的 C 指数分别为 0.81（95%CI，0.79-0.83）和 0.80（95%CI，0.77-0.83）。该列线图具有良好的校准曲线。
该列线图可以通过使用当前可用的客观参数术前预测 CRSwNP 的复发。需要进一步的研究来验证其可靠性和有效性。
