Elevated Body Mass Index Associates With Early Postoperative Recurrence in Pediatric Chronic Rhinosinusitis With Nasal Polyps

BackgroundPediatric chronic rhinosinusitis with nasal polyps (CRSwNP) is a refractory inflammatory condition characterized by a high recurrence rate, yet reliable predictive biomarkers remain scarce. This study aimed to identify potential markers for early predicting postoperative recurrence in pediatric CRSwNP patients.MethodsA total of 205 pediatric patients with CRSwNP were retrospectively enrolled and followed postoperatively. Clinical variables and disease severity scores were collected. Logistic regression, Kaplan-Meier analysis, and Cox models were applied to identify risk factors associated with postoperative recurrence.ResultsAfter 1 year of follow-up, 114 patients experienced postoperative recurrence, whereas 91 remained recurrence-free. Patients with recurrence exhibited higher body mass index (BMI) and a greater prevalence of allergic rhinitis (AR). Multivariate analyses identified BMI and AR as independent predictors of early recurrence. Kaplan-Meier analysis demonstrated that elevated BMI was associated with shorter relapse-free survival, and stratified analyses confirmed a significantly increased recurrence risk among overweight and obese patients compared with those of normal weight, independent of potential confounders. Notably, among patients with normal baseline BMI, those who became obese within 1 year after surgery had a significantly higher recurrence rate, and postoperative BMI increased significantly only in patients who experienced recurrence.ConclusionElevated BMI was an independent risk factor for early postoperative recurrence in pediatric CRSwNP, with risk increasing alongside BMI levels. Postoperative weight gain further heightened recurrence risk, suggesting BMI as a practical marker for postoperative risk stratification.