{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T06:19:20Z","timestamp":1775110760449,"version":"3.50.1"},"reference-count":38,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T00:00:00Z","timestamp":1775088000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study aimed to evaluate the predictive value of the neutrophil-to-lymphocyte ratio (NLR) for day-7 hearing recovery following oral glucocorticoid therapy in patients with idiopathic sudden sensorineural hearing loss (ISSNHL).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively reviewed the medical records of 214 patients with unilateral ISSNHL who were admitted to the Department of Otolaryngology\u2013Head and Neck Surgery between 2022 and 2025. Multivariable logistic regression was used to assess the association between baseline NLR and day-7 recovery status (recovered vs. non-recovered), and E-values were calculated to evaluate the potential impact of unmeasured confounders. Stratified analyses and interaction tests were performed to examine potential effect modifications across predefined subgroups. Receiver operating characteristic (ROC) curve analysis was conducted to assess predictive performance, and the optimal NLR threshold was determined using the Youden index. To address potential overfitting and improve reproducibility, internal validation and calibration of the NLR-only model were performed using bootstrap resampling, including the optimism-corrected AUC, Brier score, calibration-in-the-large, and calibration slope.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A higher NLR was significantly associated with a lower likelihood of day-7 hearing recovery. In the fully adjusted model, the odds ratio (OR) for NLR was 0.40 [95% confidence interval (CI), 0.30\u20130.53]. The E-value was 2.54 (upper limit of the 95% CI, 2.09), supporting the robustness to unmeasured confounding factors. This association was generally consistent across subgroup analyses. ROC analysis showed strong predictive accuracy, with an apparent AUC of 0.90 (95% CI, 0.85\u20130.95). The optimal NLR cut-off was 4.59, with a specificity of 97.66% and a sensitivity of 80.23%. Bootstrap internal validation demonstrated minimal overfitting (optimism-corrected AUC 0.90) and satisfactory calibration (optimism-corrected calibration-in-the-large = 0.0039; calibration slope = 1.0032).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Baseline NLR is a simple and readily available biomarker that predicts day-7 hearing recovery following oral glucocorticoid therapy in patients with ISSNHL. An elevated NLR is associated with a lower probability of recovery, supporting its potential utility for early risk stratification; nevertheless, external validation in independent cohorts is warranted.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1792149","type":"journal-article","created":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T05:25:52Z","timestamp":1775107552000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Association between baseline neutrophil-to-lymphocyte ratio and short-term hearing recovery after glucocorticoid therapy in idiopathic sudden sensorineural hearing loss"],"prefix":"10.3389","volume":"13","author":[{"given":"Daxiong","family":"Ding","sequence":"first","affiliation":[{"name":"Department of Otolaryngology-Head and Neck Surgery, Affiliated Hospital of North Sichuan Medical College, Nanchong","place":["Sichuan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jing","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology-Head and Neck Surgery, Affiliated Hospital of North Sichuan Medical College, Nanchong","place":["Sichuan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shan","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Respiratory and Critical Care Medicine, Affiliated Hospital of North Sichuan Medical College, Nanchong","place":["Sichuan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,4,2]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"S1","DOI":"10.1177\/0194599819859885","article-title":"Clinical Practice Guideline: sudden Hearing Loss (Update).","volume":"161","author":"Chandrasekhar","year":"2019","journal-title":"Otolaryngol Head Neck Surg."},{"key":"B2","doi-asserted-by":"publisher","first-page":"1586","DOI":"10.1097\/MAO.0000000000000222","article-title":"Incidence of sudden sensorineural hearing loss.","volume":"34","author":"Alexander","year":"2013","journal-title":"Otol Neurotol"},{"key":"B3","doi-asserted-by":"publisher","first-page":"S1","DOI":"10.1177\/0194599812436449","article-title":"Clinical practice guideline: sudden hearing loss.","volume":"146","author":"Stachler","year":"2012","journal-title":"Otolaryngol Head Neck Surg."},{"key":"B4","doi-asserted-by":"publisher","first-page":"216","DOI":"10.3122\/jabfm.2021.01.200199","article-title":"Sudden sensorineural hearing loss: a diagnostic and therapeutic emergency.","volume":"34","author":"Prince","year":"2021","journal-title":"J Am Board Fam Med"},{"key":"B5","doi-asserted-by":"publisher","first-page":"1203","DOI":"10.1016\/S0140-6736(09)62071-7","article-title":"Sudden sensorineural hearing loss.","volume":"375","author":"Schreiber","year":"2010","journal-title":"Lancet"},{"key":"B6","doi-asserted-by":"publisher","first-page":"1142","DOI":"10.1097\/MAO.0b013e3182635417","article-title":"Correlations of inflammatory biomarkers with the onset and prognosis of idiopathic sudden sensorineural hearing loss.","volume":"33","author":"Masuda","year":"2012","journal-title":"Otol Neurotol"},{"key":"B7","doi-asserted-by":"publisher","first-page":"803","DOI":"10.1038\/nri2171","article-title":"Evolving functions of endothelial cells in inflammation.","volume":"7","author":"Pober","year":"2007","journal-title":"Nat Rev Immunol"},{"key":"B8","doi-asserted-by":"publisher","first-page":"8588","DOI":"10.3390\/ijms21228588","article-title":"Hyperbaric oxygenation as adjunctive therapy in the treatment of sudden sensorineural hearing loss.","volume":"21","author":"Olex-Zarychta","year":"2020","journal-title":"Int J Mol Sci"},{"key":"B9","doi-asserted-by":"publisher","first-page":"6740","DOI":"10.1038\/s41598-020-63654-9","article-title":"Cochlear supporting cells function as macrophage-like cells and protect audiosensory receptor hair cells from pathogens.","volume":"10","author":"Hayashi","year":"2020","journal-title":"Sci Rep"},{"key":"B10","doi-asserted-by":"publisher","first-page":"853","DOI":"10.1038\/nature01321","article-title":"The inflammatory reflex.","volume":"420","author":"Tracey","year":"2002","journal-title":"Nature"},{"key":"B11","doi-asserted-by":"publisher","first-page":"55","DOI":"10.1586\/erc.12.159","article-title":"Neutrophil to lymphocyte ratio and cardiovascular diseases: a review.","volume":"11","author":"Bhat","year":"2013","journal-title":"Expert Rev Cardiovasc Ther"},{"key":"B12","doi-asserted-by":"publisher","first-page":"695","DOI":"10.1038\/bjc.2012.292","article-title":"A derived neutrophil to lymphocyte ratio predicts survival in patients with cancer.","volume":"107","author":"Proctor","year":"2012","journal-title":"Br J Cancer"},{"key":"B13","doi-asserted-by":"publisher","first-page":"dju124","DOI":"10.1093\/jnci\/dju124","article-title":"Prognostic role of neutrophil-to-lymphocyte ratio in solid tumors: a systematic review and meta-analysis.","volume":"106","author":"Templeton","year":"2014","journal-title":"J Natl Cancer Inst"},{"key":"B14","doi-asserted-by":"publisher","first-page":"8191254","DOI":"10.1155\/2016\/8191254","article-title":"Prognostic significance of neutrophil-to-lymphocyte ratio in patients with sepsis: a prospective observational study.","volume":"2016","author":"Liu","year":"2016","journal-title":"Mediators Inflamm"},{"key":"B15","doi-asserted-by":"publisher","first-page":"3651","DOI":"10.2147\/COPD.S178068","article-title":"Defining the role of neutrophil-to-lymphocyte ratio in COPD: a systematic literature review.","volume":"13","author":"Pascual-Gonz\u00e1lez","year":"2018","journal-title":"Int J Chron Obstruct Pulmon Dis"},{"key":"B16","doi-asserted-by":"publisher","first-page":"288","DOI":"10.1186\/s13054-020-03007-0","article-title":"Neutrophil-to-lymphocyte ratio as a predictive biomarker for moderate-severe ARDS in severe COVID-19 patients.","volume":"24","author":"Ma","year":"2020","journal-title":"Crit Care"},{"key":"B17","doi-asserted-by":"publisher","first-page":"7165257","DOI":"10.1155\/2019\/7165257","article-title":"Selected blood inflammatory and metabolic parameters predicted successive bilateral sudden sensorineural hearing loss.","volume":"2019","author":"Zhang","year":"2019","journal-title":"Dis Mark"},{"key":"B18","doi-asserted-by":"publisher","first-page":"636","DOI":"10.1016\/j.bjorl.2015.08.009","article-title":"Investigation of neutrophil-to-lymphocyte ratio and mean platelet volume in sudden hearing loss.","volume":"81","author":"Kum","year":"2015","journal-title":"Braz J Otorhinolaryngol"},{"key":"B19","doi-asserted-by":"publisher","first-page":"e12492","DOI":"10.1097\/MD.0000000000012492","article-title":"Neutrophil-to-lymphocyte ratio predicts diagnosis and prognosis of idiopathic sudden sensorineural hearing loss: a systematic review and meta-analysis.","volume":"97","author":"Chen","year":"2018","journal-title":"Medicine"},{"key":"B20","doi-asserted-by":"publisher","first-page":"637","DOI":"10.3760\/cma.j.cn115330-20221020-00619","article-title":"[Interpretation of guidelines\/statements\/consensus on idiopathic sudden sensorineural hearing loss].","volume":"58","author":"Liu","year":"2023","journal-title":"Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi"},{"key":"B21","doi-asserted-by":"publisher","first-page":"1616294","DOI":"10.3389\/fphar.2025.1616294","article-title":"Early administration of magnesium sulfate and its impact on clinical outcomes in ICU-admitted patients with COPD: a retrospective cohort study.","volume":"16","author":"Xiao","year":"2025","journal-title":"Front Pharmacol"},{"key":"B22","doi-asserted-by":"publisher","first-page":"1588846","DOI":"10.3389\/fphar.2025.1588846","article-title":"Association of early enoxaparin prophylactic anticoagulation with ICU mortality in critically ill patients with chronic obstructive pulmonary disease: a machine learning-based retrospective cohort study.","volume":"16","author":"Lin","year":"2025","journal-title":"Front Pharmacol"},{"key":"B23","doi-asserted-by":"publisher","first-page":"268","DOI":"10.7326\/M16-2607","article-title":"Sensitivity analysis in observational research: introducing the E-Value.","volume":"167","author":"VanderWeele","year":"2017","journal-title":"Ann Intern Med"},{"key":"B24","doi-asserted-by":"publisher","first-page":"602","DOI":"10.1001\/jama.2018.21554","article-title":"Using the E-Value to assess the potential effect of unmeasured confounding in observational studies.","volume":"321","author":"Haneuse","year":"2019","journal-title":"JAMA"},{"key":"B25","doi-asserted-by":"publisher","first-page":"747","DOI":"10.1016\/j.anl.2024.05.009","article-title":"Idiopathic sudden sensorineural hearing loss: a review focused on the contribution of vascular pathologies.","volume":"51","author":"Tsuzuki","year":"2024","journal-title":"Auris Nasus Larynx"},{"key":"B26","doi-asserted-by":"publisher","first-page":"387","DOI":"10.3109\/01677063.2011.652266","article-title":"Polymorphisms in genes involved in inflammatory pathways in patients with sudden sensorineural hearing loss.","volume":"26","author":"Hiramatsu","year":"2012","journal-title":"J Neurogenet"},{"key":"B27","doi-asserted-by":"publisher","first-page":"385","DOI":"10.1016\/j.bpa.2003.12.002","article-title":"Mechanisms of the inflammatory response.","volume":"18","author":"Sherwood","year":"2004","journal-title":"Best Pract Res Clin Anaesthesiol"},{"key":"B28","doi-asserted-by":"publisher","first-page":"343","DOI":"10.1002\/(SICI)1096-9896(200002)190:3<343::AID-PATH522>3.0.CO;2-M","article-title":"Regulation of inflammatory vascular damage.","volume":"190","author":"Lentsch","year":"2000","journal-title":"J Pathol."},{"key":"B29","doi-asserted-by":"publisher","first-page":"977","DOI":"10.1017\/S0022215123000282","article-title":"Blood tests as biomarkers for the diagnosis and prognosis of sudden sensorineural hearing loss in adults: a systematic review.","volume":"137","author":"Al-Azzawi","year":"2023","journal-title":"J Laryngol Otol"},{"key":"B30","doi-asserted-by":"publisher","first-page":"702807","DOI":"10.1155\/2014\/702807","article-title":"Neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio: novel markers for diagnosis and prognosis in patients with idiopathic sudden sensorineural hearing loss.","volume":"2014","author":"Seo","year":"2014","journal-title":"Dis Mark"},{"key":"B31","doi-asserted-by":"publisher","first-page":"1400","DOI":"10.1097\/MAO.0b013e31829b57df","article-title":"Neutrophil-to-lymphocyte ratio as a new, quick, and reliable indicator for predicting diagnosis and prognosis of idiopathic sudden sensorineural hearing loss.","volume":"34","author":"Ulu","year":"2013","journal-title":"Otol Neurotol"},{"key":"B32","doi-asserted-by":"publisher","first-page":"23","DOI":"10.1159\/000494556","article-title":"Neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio in patients with sudden sensorineural hearing loss.","volume":"28","author":"Qiao","year":"2019","journal-title":"Med Princ Pract"},{"key":"B33","doi-asserted-by":"publisher","first-page":"134","DOI":"10.1016\/j.ijporl.2019.02.023","article-title":"Predictive values of neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), and other prognostic factors in pediatric idiopathic sudden sensorineural hearing loss.","volume":"120","author":"Ha","year":"2019","journal-title":"Int J Pediatr Otorhinolaryngol"},{"key":"B34","doi-asserted-by":"publisher","first-page":"2107","DOI":"10.1007\/s00405-020-05905-z","article-title":"Investigation of the prognostic role of neutrophil-to-lymphocyte ratio in Idiopathic Sudden Sensorineural Hearing Loss based on propensity score matching: a retrospective observational study.","volume":"277","author":"Wu","year":"2020","journal-title":"Eur Arch Otorhinolaryngol"},{"key":"B35","doi-asserted-by":"publisher","first-page":"104","DOI":"10.1016\/j.cca.2018.04.025","article-title":"Prognostic role of haematological indices in sudden sensorineural hearing loss: review and meta-analysis.","volume":"483","author":"Cao","year":"2018","journal-title":"Clin Chim Acta"},{"key":"B36","doi-asserted-by":"publisher","first-page":"1","DOI":"10.5152\/iao.2025.241729","article-title":"Association between hematological indices of inflammation and pathogenesis and prognosis of sudden sensorineural hearing loss: a systematic review and meta-analysis.","volume":"21","author":"Zhao","year":"2025","journal-title":"J Int Adv Otol"},{"key":"B37","doi-asserted-by":"publisher","first-page":"1382096","DOI":"10.3389\/fneur.2024.1382096","article-title":"The inflammatory and metabolic status of patients with sudden-onset sensorineural hearing loss.","volume":"15","author":"do Amaral","year":"2024","journal-title":"Front Neurol"},{"key":"B38","doi-asserted-by":"publisher","first-page":"115","DOI":"10.2217\/bmm-2022-0729","article-title":"Associations between neutrophil-to-lymphocyte\/platelet-to-lymphocyte and recovery in sudden sensorineural hearing loss.","volume":"18","author":"Huang","year":"2024","journal-title":"Biomark Med"}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1792149\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T05:25:53Z","timestamp":1775107553000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1792149\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,2]]},"references-count":38,"alternative-id":["10.3389\/fmed.2026.1792149"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2026.1792149","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,2]]},"article-number":"1792149"}}