Analysis of risk factors for postoperative recurrence in patients with chronic rhinosinusitis with nasal polyps: A retrospective clinical cohort study

This study aims to propose a recurrence risk assessment framework that incorporates anatomical severity, inflammatory status, comorbidity profile, and treatment adherence, and assist in the early identification of high-risk patients and guide personalized postoperative interventions. A total of 152 patients with chronic rhinosinusitis with nasal polyps who underwent functional endoscopic sinus surgery at our hospital between June 2021 and June 2024 were retrospectively included. All patients completed a standardized postoperative follow-up of 6 to 36 months (median duration: 18.4 months). Based on the presence or absence of clinically confirmed recurrence during follow-up, verified by endoscopy or radiological imaging, patients were categorized into a recurrence group (n = 48) and a non-recurrence group (n = 104). Preoperative demographic data, clinical scores, biological markers, and postoperative medication adherence were systematically collected. Univariate and multivariate logistic regression analyses were performed to identify independent risk factors significantly associated with postoperative recurrence. Univariate analysis revealed that preoperative Lund-Mackay score, Lund-Kennedy score, peripheral blood eosinophil percentage > 5%, comorbidity of asthma or allergic rhinitis, and irregular use of intranasal corticosteroids postoperatively were all significantly associated with recurrence (P < .05). Multivariate logistic regression analysis showed that preoperative Lund-Mackay score (odds ratio [OR] = 1.38, 95% confidence interval [CI]: 1.16-1.65, P = .002), peripheral blood eosinophil percentage > 5% (OR = 3.62, 95% CI: 1.78-7.38, P < .001), comorbidity of asthma or allergic rhinitis (OR = 2.74, 95% CI: 1.31-5.74, P = .007), and irregular use of intranasal corticosteroids postoperatively (OR = 2.43, 95% CI: 1.16-5.11, P = .019) were independent risk factors for recurrence. Although the Lund-Kennedy score was significant in univariate analysis, it did not reach statistical significance in the multivariate model (P = .072). A higher preoperative Lund-Mackay score, elevated peripheral blood eosinophil ratio, comorbid asthma or allergic rhinitis, and poor adherence to postoperative intranasal corticosteroid use were identified as independent risk factors for postoperative recurrence in chronic rhinosinusitis with nasal polyps patients. Furthermore, the composite risk scoring model demonstrated strong predictive performance in identifying patients at high risk of recurrence, offering valuable guidance for preoperative assessment and individualized postoperative management.