Establishment and Validation of an Early Prediction Model for the Outcomes of Patients Following eCRS Endoscopic Surgery
CUI Can
WANG Huimin
LU Baocai
LI Jing
Zhou Hang
Abstract：Objective To establish an early prediction model for the prognosis of eosinophilic chronic rhinosinusitis(eCRS)after endoscopic surgery,and to test the predictive performance of the established model.Methods A total of 224 patients with eCRS treated in the First Affiliated Hospital of Xinxiang Medical University from January 2019 to August 2023 were selected and divided into a recurrence group and a non-recurrence group according to whether they had relapsed within one year after endoscopic surgery.The clinical data of the two groups were statistically analyzed,and the variables of postoperative recurrence of eCRS patients were analyzed by Lasso-logistic regression.The early prediction model of recurrence after eCRSendoscopic surgery was constructed,and the model was verified by receiver operating characteristic(ROC)curve,calibration degree and clinical decision curve.Results Among the 224 patients with eCRS,the recurrence rate within 1 year after surgery was 27.23％.The scores of the olfactory visual analog scale(VAS)[(8.00±0.64)scores vs(6.02±1.32)scores],the scores of the CT of the paranasal sinuses[(15.25±2.90)scores vs(11.10±3.05)scores],the proportion of patients with nasal septal deviation(44.26％vs 31.29％),the percentage of eosinophils in the blood(EOS)[(7.89±1.25)％vs(5.30±0.74)％],the infiltration of eosinophils in the tissue[(36.59±8.14)％vs(27.66±5.79)％],eosinophil-to-lymphocyte ratio(ELR)(0.25±0.08 vs 0.17±0.05)were higher in the recurrent group than in the non-recurrent group,and the proportion of patients who followed the treatment after surgery(62.30％vs 77.30％)was lower in the recurrent group,with statistically significant differences(P＜0.05).LASSO analysis initially screened variables as olfactory VAS score,CT score of the paranasal sinuses,nasal septal deviation,infiltration of eosinophils in the tissue,ELR,and postoperative compliance with treatment;Multivariate logistic regression analysis showed that olfactory VAS score(95％CI:1.055-1.248),sinus CT score(95％CI:1.143-1.577),nasal septum deviation(95％CI:2.068-3.491),tissue EOS infiltration(95％CI:1.074-1.563),ELR(95％CI:1.102-1.185),and postoperative compliance with medical treatment(95％CI:0.364-0.879)were significantly associated with recurrence after eCRS endoscopic surgery(P＜0.05).Based on the above factors,a patient recurrence prediction nomogram model was constructed.The results showed that the AUC of the model for predicting postoperative recurrence was 0.835(95％CI:0.774-0.895).The predicted postoperative model had good consistency with the actual results,and could achieve significant positive net benefits.Conclusion The influencing factors of patients with recurrence after eCRS endoscopic surgery are olfactory VAS score,sinus CT score,nasal septum deviation,tissue EOS infiltration,ELR,and postoperative compliance with medical treatment.The post-operative recurrence model constructed based on these factors has good performance and clinical benefits.
Keywords：chronic rhinosinusitiseosinophilicendoscopic surgeryoutcome of the diseasemodel
Publication Date：2025-06-13
Online Publishing Date：2026-09-12(First online date of this platform, not the publication date of the document)
Pages：6( 2012-2017 )