Abstract
[Objective]To investigate the risk factors for laryngopharyngeal reflux(LPR)in patients with chronic rhinosinusitis with nasal polyps(CRSwNP)after surgery and to construct a prediction model.[Methods]A total of 255 patients with CRSwNP who underwent endoscopic sinus surgery at the First People's Hospital of Zhoukou City from May 2022 to September 2024 were included.They were divided into two groups based on whether LPR occurred after surgery:the LPR group(n=93)and the non-LPR group(n=162).The risk factors for LPR in these patients were analyzed,and a prediction model was constructed.[Results]Among the 255 patients with CRSwNP who underwent endoscopic sinus surgery,93 cases(36.47%)developed LPR after surgery,while 162 cases(63.53%)did not.Comparisons between the two groups in terms of BMI,smoking history,alcohol consumption history,surgical duration,deviated nasal septum,allergic rhinitis,bronchial asthma,and sinusitis classification showed statistically significant differences(P<0.05).Multivariate logistic regression analysis was performed on the eight factors(BMI,smoking history,alcohol consumption history,surgical duration,deviated nasal septum,allergic rhinitis,bronchial asthma,and sinusitis classification)identified through univariate analysis.The results showed that BMI((O^R)=2.435,95%CI:2.021 – 2.934),smoking history((O^R)=2.181,95%CI:1.850–2.572),surgical duration((O^R)=1.935,95%CI:1.713–2.185),deviated nasal septum((O^R)=1.804,95%CI:1.570–2.073),allergic rhinitis((O^R)=1.785,95%CI:1.044–2.461),alcohol consumption history((O^R)=2.166,95%CI:1.866 – 2.514),bronchial asthma((O^R)=1.908,95%CI:1.621 – 2.245),and sinusitis classification((O^R)=1.820,95%CI:1.559–2.125)were risk factors for postoperative LPR in CRSwNP patients(P<0.05).The nomogram internal validation showed a concordance index of 0.729,and the calibration curve had a high degree of overlap with the 45-degree reference line.The area under the ROC curve(AUC=0.783,95%CI:0.677–0.889)indicated a sensitivity of 81.25%and a specificity of 67.50%,demonstrating high clinical predictive value.[Conclusion]The main risk factors for LPR in patients with chronic rhinosinusitis with nasal polyps after surgery include high BMI,smoking history,alcohol consumption history,long surgical duration,deviated nasal septum,allergic rhinitis,bronchial asthma,and pansinusitis.The prediction model based on the above factors can effectively assess the risk of postoperative LPR in patients and provide a basis for early clinical intervention and personalized treatment.关键词
慢性鼻-鼻窦炎/鼻息肉/术后/咽喉反流/危险因素/预测模型Key words
chronic rhinosinusitis/nasal polyps/postoperative/laryngopharyngeal reflux/risk factors/prediction model分类
医药卫生
