Prediction Model for Recurrence After Endoscopic Sinus Surgery in Chronic Rhinosinusitis With Nasal Polyps.

Area of Science:

• Otolaryngology
• Medical Informatics
• Biostatistics

Background:

• Chronic rhinosinusitis with nasal polyps (CRSwNP) frequently recurs after endoscopic sinus surgery (ESS).
• Predicting long-term recurrence risk remains a clinical challenge.
• A reliable prognostic model is needed for effective patient management.

Purpose of the Study:

• To identify clinical predictors of CRSwNP recurrence post-ESS.
• To develop a prognostic model for estimating recurrence-free survival.
• To provide an individualized risk assessment tool for long-term outcomes.

Main Methods:

• Retrospective cohort study of 437 CRSwNP patients undergoing ESS.
• LASSO penalized Cox regression for variable selection.
• Nomogram construction and validation using AUROC, Brier scores, and DCA.

Main Results:

• Recurrence observed in 54.0% of patients.
• Key predictors identified: age, NSAID hypersensitivity, asthma, symptom duration, blood eosinophil count (BEC), modified Lund-Kennedy (MLK), and Lund-Mackay (LM) scores.
• The nomogram showed strong predictive performance (AUROCs ranging from 0.870 to 0.886) and good calibration.

Conclusions:

• A robust, well-calibrated nomogram was developed for predicting long-term CRSwNP recurrence after ESS.
• The model utilizes key clinical and demographic factors for individualized risk assessment.
• This tool enhances clinical decision-making and patient management strategies.