title: Prognostic factors of Bell's palsy: prospective patient collected observational study.
abstract: The purpose of this study was to evaluate various parameters potentially influencing poor prognosis in Bell's palsy and to assess the predictive value for Bell's palsy. A single-center prospective patient collected observation and validation study was conducted. To evaluate the correlation between patient characteristics and poor prognosis, we performed univariate and multivariate analyzes of age, gender, side of palsy, diabetes mellitus, hypertension, and facial grading score 1 week after onset. To evaluate the accuracy of the facial grading score, we prepared a receiver operating characteristic (ROC) curve and calculated the area under the ROC curve (AUROC). We also calculated sensitivity, specificity, positive/negative likelihood ratio, and positive/negative predictive value. We included Bell's palsy patients who attended Ehime University Hospital within 1 week after onset between 1977 and 2011. We excluded patients who were less than 15 years old and lost-to-follow-up within 6 months. The main outcome was defined as non-recovery at 6 months after onset. In total, 679 adults with Bell's palsy were included. The facial grading score at 1 week showed a correlation with non-recovery in the multivariate analysis, although age, gender, side of palsy, diabetes mellitus, and hypertension did not. The AUROC of the facial grading score was 0.793. The Y-system score at 1 week moderate accurately predicted non-recovery at 6 months in Bell's palsy.
authors.affiliation: Department of Otolaryngology Head and Neck Surgery, School of Medicine, Ehime University, Shitsukawa, Toon City, Ehime, 791-0295, Japan, t.fujiwarabi@gmail.com.
authors.forename: Takashi
authors.initials: T
authors.lastname: Fujiwara
authors.forename: Naohito
authors.initials: N
authors.lastname: Hato
authors.forename: Kiyofumi
authors.initials: K
authors.lastname: Gyo
authors.forename: Naoaki
authors.initials: N
authors.lastname: Yanagihara
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D020330:Bell Palsy / Q000150:complications / Q000175:diagnosis* / Q000628:therapy; D048909:Diabetes Complications / Q000150:complications; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D012372:ROC Curve; D020127:Recovery of Function; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D012737:Sex Factors