New Risk Score Predicts Recurrence of Nasal Polyps After Surgery

After endoscopic sinus surgery, recurrence of chronic rhinosinusitis with nasal polyps (CRSwNP) may be predicted by nomogram, according to a new study.

Preoperatively predicting whether CRSwNP will recur after endoscopic sinus surgery is challenging for the clinician. To meet this challenge, researchers in China developed a nomogram that combined risk factors to predict the risk of recurrence.  

In this case, a nomogram is a set of lines representing different risk factors and risk of recurrence.  Each line has a scale marked off, and the lines are arranged so that a straight line drawn between 2 known risk factors will, when extended, connect with the risk of recurrence on another line.  

Development and validation of this recurrence-predictive nomogram was based on data from 158 patients who had endoscopic sinus surgery from 2016 to 2021 and had 3 years of follow-up. The nomogram was developed with data from 96 patients who had surgery earlier in this period and validated with data from 62 patients who had surgery later in this period, after the nomogram was developed.

Risk factors identified by univariate logistic regression using surgical patient data included blood eosinophil count, serum immunoglobulin E (IgE) level, presence or absence of asthma, and number of previous endoscopic sinus surgeries. Of the 4 peripheral risk factors incorporated into the nomogram, serum IgE level and previous surgery were found to be independent predictors of recurrence.

The researchers found a recurrence rate of 29.2% in the training cohort and of 35.5% in the validation cohort. They also found that the nomogram had a recurrence-predicting C index of 0.81 (95% CI, 0.79–0.83) in the training cohort and of 0.80 (95% CI, 0.77–0.83) in the validation cohort.

As a result, the researchers concluded that “The nomogram might be able to preoperatively predict the recurrence of CRSwNP by using currently available and objective parameters.” However, they continued, “Further studies are required to validate its reliability and effectiveness.”

—Ellen Kurek

Reference:

Du K, Zheng M, Zhao Y, et al. A nomogram combing peripheral parameter for estimation of CRSwNP recurrence. Am J Rhinol Allergy. 2021;35(5):578-586. https://doi.org/10.1177/194589242097895