Risk Predictive Model Of Otitis Media With Effusion In Children With Adenoid Hypertrophy

Objective Otitis media with effusion（OME）is a common disease in Otolaryngology,and it is common in children.Studies have shown that children with adenoid hypertrophy are more likely to suffer from OME than other children.In clinical practice,not all children with adenoid hypertrophy will suffer from OME,the occurrence of OME in children with adenoid hypertrophy is often associated with many risk factors.Through this study,we can provide a predictive model to predict which children are more susceptible to OME,and provide life guidance and health education for children with adenoid hypertrophy at risk of OME.At the same time,different treatment measures can be taken for children with or without some risk factors,so as to avoid some more serious complications caused by the operation.Methods 1.To collect the clinical data of hospitalized children from 2018 to 2021,complete information of children from 3 to 12 years old who were diagnosed as adenoid hypertrophy,according to the diagnostic criteria of OME,the children were divided into the group with OME,58 patients with OME were selected as experimental group,81 patients without OME were selected as control group by random number table,seventy children with adenoid hypertrophy who were admitted to hospital from January 2022 to March 2022 were selected by random number table for external validation of the model.2.The following information was collected:sex,age,BMI,BMI distribution,tonsil size,history of passive smoking,history of chronic rhinosinusitis,history of allergic rhinitis,history of asthma,history of recurrent respiratory infection,A/N ratio,A/N ratio grading,albumin concentration and eosinophil granulocyte percentage.3.Univariate analysis was used to analyze the two groups of patients,and the relevant factors of P<0.1 were selected into the multivariate Logistic regression model for multivariate analysis,according to the weight of each risk factor,then,the ROC curve was used to predict and evaluate the predictive model of OME in children with adenoid hypertrophy.Finally,the model was validated by data set.Results 1.Single factor analysis showed that there were significant differences in the history of chronic rhinosinusitis and passive smoking between the experimental group and the control group（P<0.05）.2.A history of chronic rhinosinusitis,passive smoking and repeated respiratory tract infections were independent risk factors for OME in children with adenoid hypertrophy.3.The formula for predicting the incidence of OME in children with adenoid hypertrophy is as follows:P=1/[1+EXP（2.738-1.608X1-1.069X2-0.984X3）].A risk scoring system for children with adenoid hypertrophy was developed,including a score of 1.6 for chronic rhinosinusitis,1.1 for passive smoking and 1 for recurrent respiratory infections,the total score ranged from 0.0 to 3.7 and the risk score≥1.4.Conclusion Children with adenoid hypertrophy who have a history of chronic rhinosinusitis,recurrent respiratory infections,and passive smoking are at increased risk for OME.In this study,the risk prediction model and the risk scoring system for children with adenoid hypertrophy were established.The area under the ROC curve was 0.701,and the area under the ROC curve was 0.791,it can be used to predict adenoid hypertrophy in children with OME,to provide life guidance for them,and to assist in the choice of treatment for OME.