Multiple Inhalant Allergen Sensitization as an Independent Risk Factor and Predictor for Chronic Rhinosinusitis With...

PurposeTo identify independent risk factors for chronic rhinosinusitis with nasal polyps (CRSwNP) and develop a clinical risk scoring system for its prediction.MethodsThis retrospective study included 420 patients categorized into CRSwNP and CRSsNP groups. Demographic, clinical (asthma), and hematologic parameters-including blood eosinophil count (BEC) and inflammatory markers-were analyzed. Subgroup stratification focused on inhalant allergen sensitization (single vs. multiple) at different BEC levels (cut-off: 0.15 × 10⁹/L). Independent risk factors were identified via multivariate logistic regression, and an integer-based scoring system was developed.ResultsCRSwNP patients showed significantly higher BEC, asthma prevalence, and multiple sensitization rates (p < 0.05). In the low-BEC population (<0.15 × 10⁹/L), multiple inhalant sensitization-but not single sensitization-was associated with higher polyp incidence (p < 0.05). Multivariate analysis confirmed asthma (OR = 4.914), elevated BEC (OR = 2.364), and multiple inhalant allergen sensitization (OR = 2.298) as independent risk factors. A scoring system (0-4 points) based on these factors demonstrated good predictive efficacy with an area under the ROC curve (AUC) of 0.770.ConclusionMultiple inhalant allergen sensitization is a key independent predictor for CRSwNP, particularly in non-eosinophilic patients. The proposed scoring system provides a practical tool for early identification and intervention in high-risk patients.