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Development and validation of a nomogram for predicting poor operative visibility during FESS in Chinese adult
Deping Sun1, Yalan Liang1, Fuwei Yang1
1Department of Otorhinolaryngology Head and Neck Surgery, The Fourth Clinical College of Chongqing Medical University, Chongqing, China.
Frontiers in Medicine
|May 14, 2024
Summary
This study developed a nomogram to predict poor operative visibility during functional endoscopic sinus surgery (FESS). The tool accurately identifies high-risk patients, aiding preoperative planning and perioperative management for chronic rhinosinusitis.
Area of Science:
- Otolaryngology
- Surgical Oncology
- Medical Informatics
Background:
- Chronic rhinosinusitis (CRS) management often involves functional endoscopic sinus surgery (FESS).
- Poor operative visibility during FESS can complicate procedures and affect outcomes.
- Predictive tools for intraoperative conditions are crucial for surgical planning.
Purpose of the Study:
- To develop and validate a predictive nomogram for poor operative visibility during FESS.
- To identify key risk factors associated with poor surgical field in FESS patients.
Main Methods:
- Retrospective analysis of 369 CRS patients undergoing FESS.
- Utilized LASSO and multivariate logistic regression to identify risk factors.
- Developed and evaluated a nomogram using training and verification datasets with ROC analysis, calibration curves, and decision curve analysis.
Main Results:
- Identified six risk factors: prothrombin time (PT), prothrombin activity (PTA), Lund-Mackay score (LMS), Lund-Kennedy score (LKS), anesthetic method, and intraoperative hypertension.
- The nomogram achieved an AUC of 0.820 (training set) and 0.852 (verification set).
- Demonstrated good calibration, clinical usefulness, and net benefit.
Conclusions:
- The developed nomogram effectively predicts poor intraoperative visibility in FESS for CRS patients.
- This tool aids in preoperative risk assessment and informs perioperative management strategies.
- Enhances surgical planning and potentially improves patient outcomes in FESS.
