Nomogram For Predicting The Prognosis Of Idiopathic Suddensensorineural Hearing Loss

ObjectiveThe purpose of this study was to create a nomogram for accurately predicting the prognostic of idiopathic sudden sensorineural hearing loss(ISSNHL),and provide a reference for clinical treatment.MethodsThe clinical data of 323 patients with ISSNHL admitted to The First Affiliated Hospital of Nanchang University from September 2014 to November 2020 were retrospectively reviewed.Prognostic factors for ISSNHL were assessed based on univariate and multivariate logistic regression analysis and used to create a nomogram.Nomogram performance in terms of predictive and discriminatory ability was evaluated by using Concordance index(C-index)and calibration plots.ResultsA total of 323 ISSNHL patients were analyzed,including 34 cases of low frequency decline type(10.2%),28 cases of high frequency decline type(8.7%),88 cases of flat decline type(27.2%),174 cases of total deafness(53.9%).The overall hearing improvement cases was 134(41.4%),of which 43 cases were cured(13.3%),55 cases were markedly effective(17.0%),36 cases were effective(11.1%),and 189 cases were ineffective(58.6%).Univariate Logistics regression analysis showed that age,total cholesterol,vertigo,diabetes,low density lipoprotein,clinical classification and time of onset were potential factors affecting the prognosis of idiopathic sudden deafness.Hyperbaric oxygen treatment had no significant effect on the prognosis of idiopathic sudden deafness.Multivariate logistic regression analysis showed that age,Low density lipoprotein(LDL),Interval between onset and treatment,symptoms of vertigo and Typing of hearing loss were independent predictors for ISSNHL.The ISSNHL patients with advanced age,symptoms of vertigo,no active treatment within2 weeks after onset,LDL ≥ 4.1mmol/L and hearing curve with total deafness or high frequency decline had a poor prognosis.We created a nomogram by using these five factors,the C index of our nomogram was 0.798 with a 95% confidence interval from0.750 to 0.845,indicating that the prediction ability and accuracy of the model are good,and the calibration plots was drawn.ConclusionsOur nomogram was a helpful tool for predicting the prognosis of ISSNHL,and may provide reference for medical staff to make optimal clinical decisions.