Introduction
Chronic rhinosinusitis (CRS) is a multifactorial heterogeneous disease, although its pathogenesis and precise mechanism remains largely unclear. Due to the poor understanding of the pathophysiology of CRS, it affects the quality of life of patients and increases the cost burden as compared to people without CRS. It is estimated to affect 8% of the adult population in China. 1 According to the EPOS2020, the current treatment for CRS includes medical therapy and FESS with the final target to achieve cure or clinical control.2 Although, the disease state of more than 30% of patients with nasal polyps, remains uncontrolled despite the current medical therapy (AMT) and FESS.3 DeConde et al also reported the disease relapse in 40% of patients with nasal polyps after 18 months. 4 The latest evidence has further indicated that the underlying diversity of endotypes might be a crucial reason for the unconformity in clinical phenotype and disease prognosis.5 Therefore, it is essential to find relevant clinical markers and to make a convenient model to predict the poor disease control in CRS.
Emerging evidence has proven that eosinophil(EOS)inflammation is a dominant factor associated with CRS recurrence and poor disease control.6In addition to the local eosinophils, peripheral blood eosinophils are also associated with CRS and can be a reliable marker for predicting the prognosis of CRS. Some studies have demonstrated the peripheral blood eosinophil as a marker for the EOS CRS. 6 In a recent study, Guiherme et al, suggested that asthma was a dominant factor for the recurrence of chronic rhinosinusitis. 7Nonetheless, some studies have reported that inhalant allergens may lead to poor sinus CT and endoscopic scores. But several studies have found no difference in allergic and nonatopic patients on the sinusitis severity. 8 Thus, it is deemed necessary to evaluate the role of allergy in nasal polyps’ disease control.
Undeniably studies on predictive factors of CRS treatment outcomes are crucial and can help improvise personalized and integration management of CRS in various hospitals. Therefore, this study aims to evaluate the risk factors involved in the prognosis of CRS after 1 year of undergoing endoscopic sinus surgery and combined the risk factors to establish a convenient and accurate prediction model.