Kun Du1, Ming Zheng1, Yan Zhao2, Chunyuan Jiao3, Wenbin Xu4, Yun Hao1, Yue Wang1, Jinming Zhao1, Xiangdong Wang1,2, Luo Zhang1,2,5,6. 1. Department of Otorhinolaryngology-Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China. 2. Beijing Institute of Otolaryngology, Beijing Key Laboratory of Nasal diseases, Beijing, China. 3. Jiaxiang Road Community Health Service Center, Qingdao Fifth People's Hospital, Qingdao, China. 4. Department of Medical Genetics, Institute of Basic Medical Science, Chinese Academy of Medical Science & Peking Union Medical Collage, Beijing, China. 5. Department of Allergy, Beijing Tongren Hospital, Capital Medical University, Beijing, China. 6. Research Unit of Diagnosis and Treatment of Chronic Nasal Diseases, Chinese Academy of Medical Sciences, Beijing, China.
Abstract
BACKGROUND: The preoperative prediction of the recurrence of chronic rhinosinusitis with nasal polyps (CRSwNP) remains difficult in clinical practice. OBJECTIVE: We aimed to develop a nomogram that combined peripheral risk factors to clinically predict the recurrence of CRSwNP. METHODS: 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. RESULTS: 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. CONCLUSION: 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.
BACKGROUND: The preoperative prediction of the recurrence of chronic rhinosinusitis with nasal polyps (CRSwNP) remains difficult in clinical practice. OBJECTIVE: We aimed to develop a nomogram that combined peripheral risk factors to clinically predict the recurrence of CRSwNP. METHODS: 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. RESULTS: 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. CONCLUSION: 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.
Authors: Junqin Bai; Julia H Huang; Caroline P E Price; Jacob M Schauer; Lydia A Suh; Regan Harmon; David B Conley; Kevin C Welch; Robert C Kern; Stephanie Shintani-Smith; Anju T Peters; Whitney W Stevens; Atsushi Kato; Robert P Schleimer; Bruce K Tan Journal: J Allergy Clin Immunol Date: 2022-03-16 Impact factor: 14.290