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

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.