Analysis of Adverse Prognostic Factors in Patients with Chronic Rhinosinusitis with Nasal Polyp and Construction of Model

GAO Ge; LIU Chenchen; DU Huihui

doi:10.3969/j.issn.1004-437X.2024.20.014

Abstract：Objective To investigate the influencing factors of poor postoperative prognosis in patients with chronic rhinosinusitis with nasal polyp(CRSwNP),establish logistic regression model and verify it,and provide reference for clinical prevention and treatment.Methods A retrospective study was conducted on 158 patients with CRSwNP admitted to the 7th People's Hospital of Zhengzhou from January 2021 to January 2023.The patients were divided into a poor prognosis group of 33 cases and a good prognosis group of 125 cases based on the prognosis after endoscopic surgery.The clinical data of the two groups were compared,and the influencing factors of poor prognosis were analyzed.A model was constructed based on the results of a multivariate logistic regression analysis,and the Hosmer-Lemeshow test was used to calibrate the model.Results Allergic rhinitis,bronchial asthma,head/face pain score,sinus CT score,postoperative infection,and interleukin-17(IL-17)and chemokine 4(CCL4)levels were independent risk factors for poor prognosis(P＜0.05).The area under the curve(AUC)of the model for predicting poor postoperative prognosis was 0.906(95％CI:0.812-0.964),with a sensitivity and specificity of 84.85％ and 86.40％,respectively,and good calibration.Conclusion Allergic rhinitis,bronchial asthma,head/face pain score,sinus CT score,postoperative infection,and IL-17 and CCL4 levels are independent risk factors for poor prognosis in CRSwNP patients after surgery.Based on these factors,a logistic regression model was established,which has certain predictive value for the occurrence of poor prognosis.Clinical attention should be paid to these factors and individualized interventions should be implemented to reduce the risk of poor prognosis.