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Systemic immune‑inflammation index and neutrophil‑to‑lymphocyte ratio predict treatment responses in elderly patients with profound sudden deafness

  • Authors:
    • Chong Li
    • Huili Wu
    • Hongxia Cui
    • Yue Li
    • Zhiming Sun
    • Siqi Haoliu
    • Xinfa Wei
  • View Affiliations / Copyright

    Affiliations: Department of Otolaryngology, Emergency General Hospital, Beijing 100028, P.R. China
    Copyright: © Li et al. This is an open access article distributed under the terms of Creative Commons Attribution License.
  • Article Number: 161
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    Published online on: April 9, 2026
       https://doi.org/10.3892/etm.2026.13156
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Abstract

The aim of the present study was to evaluate the potential role of the neutrophil‑to‑lymphocyte ratio (NLR) and the systemic immune‑inflammation index (SII) in predicting hearing recovery among elderly patients with profound sudden sensorineural hearing loss (SSNHL) following steroid treatment. The present retrospective study analyzed data from 186 elderly patients with profound SSNHL. Clinical characteristics and laboratory parameters were assessed to identify independent predictors of hearing outcomes using logistic regression and receiver operating characteristic (ROC) analyses. Baseline characteristics were generally comparable across groups; however, NLR, SII, total bilirubin (TBIL) and C‑reactive protein (CRP) were significantly elevated in the non‑recovery group (P<0.001). Multivariate logistic regression analysis further demonstrated that elevated NLR and SII were independent risk factors for poor hearing recovery; notably, increased CRP and TBIL levels were also independently associated with a higher likelihood of no recovery. ROC analysis demonstrated that both the NLR [area under the curve (AUC)=0.809] and SII (AUC=0.862) possessed a strong discriminatory ability for identifying non‑recovery. In an exploratory analysis, the combined use of CRP, TBIL, SII and NLR achieved the highest predictive performance for distinguishing no recovery from complete recovery, with an AUC of 0.951 (95% CI, 0.907‑0.996; P<0.001). Overall, elevated NLR and SII were independent predictors of poor hearing recovery in elderly patients with profound SSNHL. These readily available inflammatory markers may serve as useful prognostic tools for outcome stratification in clinical practice.
View Figures

Figure 1

ROC analysis of CRP, SII, NLR and the
combination of SII + NLR in distinguishing patients with partial
recovery from patients with complete recovery in elderly patients
with profound sudden deafness. (A) ROC curves of CRP; (B) ROC
curves of the SII; (C) ROC curves of the NLR; and (D) ROC curves of
the combined model incorporating SII and NLR. The AUC and
corresponding P-values are indicated in each panel. CRP, C-reactive
protein; SII, systemic immune-inflammation index; NLR,
neutrophil-to-lymphocyte ratio; AUC, area under the curve; ROC,
receiver operating characteristic.

Figure 2

Receiver operating characteristic
curves of CRP, TBIL, SII, NLR and their combination for predicting
no recovery vs. complete recovery in elderly patients with profound
sudden deafness. (A) ROC curves of CRP; (B) ROC curves of TBIL; (C)
ROC curves of SII; (D) ROC curves of NLR; and (E) ROC curves of the
combined model incorporating CRP, TBIL, SII and NLR. The AUC and
corresponding P-values are indicated in each panel. CRP, C-reactive
protein; TBIL, total bilirubin; SII, systemic immune-inflammation
index; NLR, neutrophil-to-lymphocyte ratio; AUC, area under the
curve; ROC, receiver operating characteristic.
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Copy and paste a formatted citation
Spandidos Publications style
Li C, Wu H, Cui H, Li Y, Sun Z, Haoliu S and Wei X: Systemic immune‑inflammation index and&nbsp;neutrophil‑to‑lymphocyte ratio predict treatment responses in elderly patients with profound sudden deafness. Exp Ther Med 31: 161, 2026.
APA
Li, C., Wu, H., Cui, H., Li, Y., Sun, Z., Haoliu, S., & Wei, X. (2026). Systemic immune‑inflammation index and&nbsp;neutrophil‑to‑lymphocyte ratio predict treatment responses in elderly patients with profound sudden deafness. Experimental and Therapeutic Medicine, 31, 161. https://doi.org/10.3892/etm.2026.13156
MLA
Li, C., Wu, H., Cui, H., Li, Y., Sun, Z., Haoliu, S., Wei, X."Systemic immune‑inflammation index and&nbsp;neutrophil‑to‑lymphocyte ratio predict treatment responses in elderly patients with profound sudden deafness". Experimental and Therapeutic Medicine 31.6 (2026): 161.
Chicago
Li, C., Wu, H., Cui, H., Li, Y., Sun, Z., Haoliu, S., Wei, X."Systemic immune‑inflammation index and&nbsp;neutrophil‑to‑lymphocyte ratio predict treatment responses in elderly patients with profound sudden deafness". Experimental and Therapeutic Medicine 31, no. 6 (2026): 161. https://doi.org/10.3892/etm.2026.13156
Copy and paste a formatted citation
x
Spandidos Publications style
Li C, Wu H, Cui H, Li Y, Sun Z, Haoliu S and Wei X: Systemic immune‑inflammation index and&nbsp;neutrophil‑to‑lymphocyte ratio predict treatment responses in elderly patients with profound sudden deafness. Exp Ther Med 31: 161, 2026.
APA
Li, C., Wu, H., Cui, H., Li, Y., Sun, Z., Haoliu, S., & Wei, X. (2026). Systemic immune‑inflammation index and&nbsp;neutrophil‑to‑lymphocyte ratio predict treatment responses in elderly patients with profound sudden deafness. Experimental and Therapeutic Medicine, 31, 161. https://doi.org/10.3892/etm.2026.13156
MLA
Li, C., Wu, H., Cui, H., Li, Y., Sun, Z., Haoliu, S., Wei, X."Systemic immune‑inflammation index and&nbsp;neutrophil‑to‑lymphocyte ratio predict treatment responses in elderly patients with profound sudden deafness". Experimental and Therapeutic Medicine 31.6 (2026): 161.
Chicago
Li, C., Wu, H., Cui, H., Li, Y., Sun, Z., Haoliu, S., Wei, X."Systemic immune‑inflammation index and&nbsp;neutrophil‑to‑lymphocyte ratio predict treatment responses in elderly patients with profound sudden deafness". Experimental and Therapeutic Medicine 31, no. 6 (2026): 161. https://doi.org/10.3892/etm.2026.13156
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