Construction Of A Risk Prediction Model For Adenoid Hypertrophy Complicated By Chronic Sinusitis In Children With Columnar Maps

Background:Adenoid hypertrophy is an obstructive disease caused by the proliferation of adenoid lymphoid tissue and is the main cause of nasal congestion in children,with an incidence of about 34.46%.Without timely intervention,other problems can develop,such as open-mouth breathing,otitis media,sleep apnea hypoventilation syndrome,and upper respiratory tract infections.6-7% of children with upper respiratory tract infections may progress to adenoiditis and acute sinusitis,and some acute sinusitis may progress to chronic sinusitis.Adenoid hypertrophy in children complicated by chronic sinusitis seriously affects the life and learning of the child,and even serious complications such as heart and lung diseases occur.Therefore,the risk factors for adenoid hypertrophy complicated by chronic sinusitis in children should be identified as early as possible.In recent years,the relationship between adenoid hypertrophy and chronic sinusitis in children has been extensively studied,and it was found that only some children with adenoid hypertrophy were complicated by chronic sinusitis,suggesting that there may be some factor that promotes adenoid hypertrophy complicated by chronic sinusitis in children.Objective:To investigate the risk factors that may contribute to the complication of chronic sinusitis in children with adenoid hypertrophy and to construct an individualized line graph risk prediction model.To help clinicians screen children at high risk for chronic sinusitis,provide them with life coaching and health education,achieve secondary prevention of the disease,and reduce the burden of the disease.Methods:The medical records of 300 children who underwent adenoidectomy at the First Affiliated Hospital of Henan University from August 2019 to August 2022 were retrospectively collected and divided into experimental and control groups according to whether they were complicated by chronic sinusitis,comparing the general data of the two groups,analyzing the risk factors of adenoid hypertrophy complicated by chronic sinusitis in children by using multi-factor logistic regression analysis,establishing the risk prediction model of adenoid hypertrophy complicated by chronic sinusitis in children The risk prediction model of chronic sinusitis in children with adenoidal hypertrophy was established and the line graphs were drawn.The H-L goodness-of-fit test(Hosmer-Lemeshow test)was used to evaluate the goodness-of-fit of the line graph model,calibration curves were drawn to assess the consistency of the line graph prediction model,and subject operating characteristic(ROC)curves were drawn to assess the predictive efficiency of the line graph model.Results:1.Univariate analysis showed that the differences between the experimental and control groups were statistically significant(P < 0.05)for four variables: history of passive smoking,history of recurrent upper respiratory tract infections,history of allergic rhinitis,and adenoid IV hypertrophy,and there were no statistically significant differences between the experimental and control groups for age,sex,BMI,and degree of tonsillar hypertrophy(P > 0.05).2.Multifactorial logistic regression analysis revealed that history of passive smoking(OR=1.865,P=0.031),history of recurrent upper respiratory tract infections(OR=2.581,P=0.001),history of allergic rhinitis(OR=5.342,P<0.001),and adenoids IV hypertrophy(OR=2.995,P<0.001)were independent risk factors for childhood Adenoid hypertrophy complicating chronic sinusitis was an independent risk factor.The formula for constructing the risk prediction model was P=1/[1+exp(2.602-0.623×history of passive smoking-0.948×history of recurrent upper respiratory tract infection-1.676×history of allergic rhinitis-1.097×adenoids IV degree hypertrophy)].3.The efficacy of the model for predicting the risk of chronic sinusitis in children with adenoidal hypertrophy: the goodness of fit H-L(χ2=9.886,P>0.05)suggests that the model fits well.the area under the ROC curve(AUC)was 0.783(95% CI:0.724-0.841),with a sensitivity of 72.5% and a specificity of 73.2%,suggesting that the model The discrimination of the model was good.The calibration curve confirmed that the model predicted results were in good agreement with the actual occurrence results.Conclusions:History of passive smoking,history of recurrent upper respiratory tract infections,history of allergic rhinitis,and adenoid IV hypertrophy are risk factors for adenoid hypertrophy complicated by chronic sinusitis in children,and the more risk factors exposed,the higher the probability of complicating chronic sinusitis.The column line graph risk prediction model of childhood adenoid hypertrophy complicated by chronic sinusitis constructed in this study has good differentiation and calibration,which can help guide clinicians to screen high-risk groups and achieve early prevention and intervention,thus reducing the prevalence of childhood AH complicated by CRS,improving prognosis and promoting recovery,and has strong generalizability.