Risk prediction model and efficacy evaluation for postoperative recurrence of chronic suppurative otitis media established based on serum procalcitonin, soluble interleukin-2 receptor and clinical characteristics

doi:10.3877/cma.j.issn.1674-1358.2025.04.005

Abstract

Abstract:

Objective

To explore the influencing factors of postoperative recurrence of chronic suppurative otitis media (CSOM), and to construct the relevant prediction model of postoperative recurrence based on procalcitonin (PCT), soluble interleukin-2 receptor (sIL-2R) and clinical characteristics.

Methods

The clinical data of 400 patients with CSOM who were treated by surgery and reached the cure standard in Chengdu Seventh People’s Hospital from June 2018 to June 2023 were collected, retrospectively. After following-up for one year, the patients were divided into recurrence group (31 cases) and non-recurrence group (369 cases) according to whether they had recurrence. The influencing factors of postoperative recurrence of CSOM were analyzed by univariate analysis and multivariate Logistic regression analysis models, and a risk prediction model for postoperative recurrence of CSOM based on PCT, sIL-2R and clinical characteristics was established, and the predictive efficacy of the risk prediction model was analyzed by receiver operating characteristic (ROC) curve.

Results

Age (χ²=3.955, P=0.047), impatency of eustachian tube (χ²=3.955, P=0.047), repeated upper respiratory tract infection (χ²=5.679, P=0.017), fasting blood glucose (t=4.741, P < 0.001), postoperative PCT level (t=3.488, P=0.001) and sIL-2R level (t = 2.864, P=0.004) between patients in recurrence group and non-recurrence group were all significantly different. The results of the binary Logistic regression model showed that impatency of eustachian tube (OR=2.492, 95%CI: 1.062-5.852, P=0.036), recurrent upper respiratory tract infection (OR=3.830, 95%CI: 1.668-8.791, P=0.002), fasting blood glucose (OR=2.843, 95%CI: 1.643-4.919, P < 0.001), postoperative PCT level (OR=155.371, 95%CI: 3.650-6 613.023, P=0.008) and sIL-2R level (OR=1.007, 95%CI: 1.001-1.014, P=0.029) were all independent risk factors for CSOM recurrence after surgery. According to the results of Logistic regression analysis, the prediction model equation was obtained: G=Log (P)=0.923 × impatency of eustachian tube + 1.299 × repeated upper respiratory tract infection + 1.093 × fasting blood glucose + 5.367 × postoperative PCT + 0.007 × sIL-2R-14.803. ROC curve analysis of the predictive model showed that AUC of this predictive model was 0.819 (95%CI: 0.737-0.902), suggesting a good predictive value for postoperative recurrence of CSOM.

Conclusions

Eustachian tube obstruction, repeated upper respiratory tract infection, fasting blood glucose, postoperative PCT level and sIL-2R level are all risk factors for recurrence after CSOM surgery. The predictive model constructed based on these factors has certain predictive value.

Key words: Chronic suppurative otitis media, Postoperative recurrence, Procalcitonin, Soluble interleukin-2 receptor, Prediction model

Wei Li, Qian Wang, E Zhang, Guanghui Zhang. Risk prediction model and efficacy evaluation for postoperative recurrence of chronic suppurative otitis media established based on serum procalcitonin, soluble interleukin-2 receptor and clinical characteristics[J]. Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition), 2025, 19(04): 223-229.

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References 26

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临床资料	复发组（31例）	未复发组（369例）	统计量	P值
性别[例（%）]			χ²=0.173^a	0.677
男	17（54.84）	188（50.95）
女	14（45.16）	181（49.05）
年龄（±s，岁）	58.61 ± 6.39	56.13±6.09	t=2.176	0.030
病程（±s，年）	4.23±1.06	4.26 ± 1.19	t=0.186	0.867
病变部位[例（%）]			χ²=0.594^a	0.441
左耳	16（51.61）	164（44.44）
右耳	15（48.39）	205（55.56）
活动期发病时间（±s，d）	6.90±0.83	6.75±0.81	t=0.985	0.325
发病频次（±s，次）	2.87±0.85	2.67±0.78	t=1.379	0.169
鼓膜张肌腱[例（%）]			χ²=2.623^a	0.105
有	27（87.10）	273（73.98）
无	4（12.90）	96（26.02）
鼓室黏膜病变[例（%）]			χ²=0.064^a	0.800
有	21（67.74）	258（69.92）
无	10（32.26）	111（30.08）
咽鼓管[例（%）]			χ²=3.955^a	0.047
不通	13（41.94）	94（25.47）
通畅	18（58.06）	275（74.53）
反复上呼吸道感染[例（%）]			χ² = 5.679^a	0.017
有	12（38.71）	75（20.33）
无	19（61.29）	294（79.67）
慢性鼻窦炎[例（%）]			χ²=2.255^a	0.133
有	8（25.81）	57（15.45）
无	23（74.19）	312（84.55）
通气管[例（%）]			χ²=1.655^a	0.198
有	3（9.68）	70（18.97）
无	28（90.32）	299（81.03）
血清白蛋白（±s，g/L）	33.71±5.64	32.23 ± 6.17	t=1.288	0.198
空腹血糖（±s，mmol/L）	6.32±0.85	5.71±0.67	t=4.741	<0.001
术后PCT（±s，μg/L）	0.54±0.13	0.47±0.11	t=3.488	0.001
sIL-2R（±s，U/ml）	334.32±73.64	298.68±65.94	t=2.864	0.004

临床资料	复发组（31例）	未复发组（369例）	统计量	P值
性别[例（%）]			χ²=0.173^a	0.677
男	17（54.84）	188（50.95）
女	14（45.16）	181（49.05）
年龄（±s，岁）	58.61 ± 6.39	56.13±6.09	t=2.176	0.030
病程（±s，年）	4.23±1.06	4.26 ± 1.19	t=0.186	0.867
病变部位[例（%）]			χ²=0.594^a	0.441
左耳	16（51.61）	164（44.44）
右耳	15（48.39）	205（55.56）
活动期发病时间（±s，d）	6.90±0.83	6.75±0.81	t=0.985	0.325
发病频次（±s，次）	2.87±0.85	2.67±0.78	t=1.379	0.169
鼓膜张肌腱[例（%）]			χ²=2.623^a	0.105
有	27（87.10）	273（73.98）
无	4（12.90）	96（26.02）
鼓室黏膜病变[例（%）]			χ²=0.064^a	0.800
有	21（67.74）	258（69.92）
无	10（32.26）	111（30.08）
咽鼓管[例（%）]			χ²=3.955^a	0.047
不通	13（41.94）	94（25.47）
通畅	18（58.06）	275（74.53）
反复上呼吸道感染[例（%）]			χ² = 5.679^a	0.017
有	12（38.71）	75（20.33）
无	19（61.29）	294（79.67）
慢性鼻窦炎[例（%）]			χ²=2.255^a	0.133
有	8（25.81）	57（15.45）
无	23（74.19）	312（84.55）
通气管[例（%）]			χ²=1.655^a	0.198
有	3（9.68）	70（18.97）
无	28（90.32）	299（81.03）
血清白蛋白（±s，g/L）	33.71±5.64	32.23 ± 6.17	t=1.288	0.198
空腹血糖（±s，mmol/L）	6.32±0.85	5.71±0.67	t=4.741	<0.001
术后PCT（±s，μg/L）	0.54±0.13	0.47±0.11	t=3.488	0.001
sIL-2R（±s，U/ml）	334.32±73.64	298.68±65.94	t=2.864	0.004

影响因素	β值	S.E.值	Wald χ²值	P值	OR值	95%CI
年龄	0.051	0.035	2.122	0.145	1.052	0.983～1.127
咽鼓管不通	0.913	0.435	4.399	0.036	2.492	1.062～5.852
反复上呼吸道感染	1.343	0.424	10.031	0.002	3.830	1.668～8.791
空腹血糖	1.045	0.280	13.947	<0.001	2.843	1.643～4.919
术后PCT	5.046	1.914	6.951	0.008	155.371	3.650～6 613.023
sIL-2R	0.007	0.003	4.797	0.029	1.007	1.001～1.014
常量	－17.255	2.914	35.054	<0.001	—	—

影响因素	β值	S.E.值	Wald χ²值	P值	OR值	95%CI
年龄	0.051	0.035	2.122	0.145	1.052	0.983～1.127
咽鼓管不通	0.913	0.435	4.399	0.036	2.492	1.062～5.852
反复上呼吸道感染	1.343	0.424	10.031	0.002	3.830	1.668～8.791
空腹血糖	1.045	0.280	13.947	<0.001	2.843	1.643～4.919
术后PCT	5.046	1.914	6.951	0.008	155.371	3.650～6 613.023
sIL-2R	0.007	0.003	4.797	0.029	1.007	1.001～1.014
常量	－17.255	2.914	35.054	<0.001	—	—

影响因素	β值	S.E.值	Wald χ²值	P值	OR值	95%CI
咽鼓管不通	0.923	0.433	4.552	0.033	2.518	1.078～5.882
反复上呼吸道感染	1.299	0.419	9.608	0.002	3.666	1.612～8.337
空腹血糖	1.093	0.278	15.465	0.000	2.984	1.730～5.145
术后PCT	5.367	1.908	7.914	0.005	214.274	5.093～9 014.388
sIL-2R	0.007	0.003	4.923	0.027	1.007	1.001～1.014
常量	－14.803	2.321	40.667	<0.001	0.000	—

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