[Construction and validation of a prognosis prediction model for patients with high-frequency predominant sudden sensorineural hearing loss with concomitant middle- and low-frequency involvement].

Objective: To investigate the prognostic factors of high-frequency predominant sudden sensorineural hearing loss with concomitant middle- and low-frequency involvement, and develop a prognostic prediction model. Methods: The clinical data of patients with high-frequency predominant sudden sensorineural hearing loss with concomitant middle-and low-frequency involvement at the Chinese PLA General Hospital between January 2009 and April 2025 were retrospectively analyzed. Patients were divided into effective and ineffective groups based on their prognosis. A prognostic prediction model was established using multivariable logistic regression analysis, and a nomogram was constructed. The performance of the model was evaluated by receiver operating characteristic (ROC) curve, Hosmer-Lemeshow goodness-of-fit test, and decision curve analysis (DCA). Results: A total of 170 patients aged 48 (38, 56) years were included, comprising 96 males (56.5%) and 74 females (43.5%). The overall treatment effective rate was 27.6% (47/170). Multivariable logistic regression analysis showed that prolonged time from onset to presentation (OR=1.17, 95%CI: 1.10-1.26, P<0.001), increased age (OR=1.09, 95%CI: 1.05-1.13, P<0.001), and decreased high-density lipoprotein cholesterol (HDL-C) (OR=4.00, 95%CI: 1.21-13.20, P=0.023) were independent risk factors for poor prognosis in patients with high-frequency predominant sudden sensorineural hearing loss with concomitant middle- and low-frequency involvement. The area under the ROC curve (AUC) of the prediction model was 0.88 (95%CI: 0.82-0.93). The calibration curve demonstrated good fit, with the Hosmer-Lemeshow goodness-of-fit test yielding χ2=7.157 and P=0.520. DCA showed that the model yielded a positive net benefit when the risk threshold probability ranged from 0.04 to 0.99. Conclusions: Time from onset to presentation, age, and HDL-C are prognostic factors in patients with high-frequency predominant sudden sensorineural hearing loss with concomitant middle- and low-frequency involvement. The nomogram developed based on these variables demonstrates good predictive ability for treatment prognosis in these patients.