Multiple Inhalant Allergen Sensitization as an Independent Risk Factor and Predictor for Chronic Rhinosinusitis With Nasal Polyps

Purpose To identify independent risk factors for chronic rhinosinusitis with nasal polyps (CRSwNP) and develop a clinical risk scoring system for its prediction. Methods This retrospective study included 420 patients categorized into CRSwNP and CRSsNP groups. Demographic, clinical (asthma), and hematologic parameters—including blood eosinophil count (BEC) and inflammatory markers—were analyzed. Subgroup stratification focused on inhalant allergen sensitization (single vs. multiple) at different BEC levels (cut-off: 0.15 × 10 9 /L). Independent risk factors were identified via multivariate logistic regression, and an integer-based scoring system was developed. Results CRSwNP patients showed significantly higher BEC, asthma prevalence, and multiple sensitization rates (p < 0.05). In the low-BEC population (<0.15 × 10 9 /L), multiple inhalant sensitization—but not single sensitization—was associated with higher polyp incidence (p < 0.05). Multivariate analysis confirmed asthma (OR = 4.914), elevated BEC (OR = 2.364), and multiple inhalant allergen sensitization (OR = 2.298) as independent risk factors. A scoring system (0–4 points) based on these factors demonstrated good predictive efficacy with an area under the ROC curve (AUC) of 0.770. Conclusion Multiple inhalant allergen sensitization is a key independent predictor for CRSwNP, particularly in non-eosinophilic patients. The proposed scoring system provides a practical tool for early identification and intervention in high-risk patients.