Baseline Inflammation, Albumin, and 90-Day Mortality in Sinonasal Mucormycosis: A Retrospective Cohort Study

Sinonasal mucormycosis is an angioinvasive fungal infection associated with rapid local progression and substantial mortality. This study described the clinical characteristics of histopathologically confirmed sinonasal mucormycosis and evaluated baseline factors associated with all-cause 90-day mortality. This retrospective single-center cohort included 60 patients treated between January 2016 and March 2026. The primary outcome was all-cause mortality within 90 days of the index presentation. Exploratory adjusted associations were evaluated using Firth penalized logistic regression including age, hematological malignancy, neutrophil-to-lymphocyte ratio (NLR), and serum albumin. Radiological extent was not included in this model. A separate logistic model containing NLR and albumin only was evaluated for discrimination, with optimism assessed using 1000 bootstrap resamples. Twenty-two patients died within 90 days (36.7%). Non-survivors more frequently had hematological malignancy, corticosteroid exposure, neutropenia, and advanced radiological extension. In the adjusted model, higher NLR was associated with increased odds of mortality (adjusted odds ratio [aOR] per 5-unit increase, 1.45; 95% confidence interval [CI], 1.06–2.02; p = 0.023), whereas higher albumin was associated with lower odds of mortality (aOR per 0.5 g/dL increase, 0.72; 95% CI, 0.52–0.98; p = 0.039). The separate two-biomarker model had an apparent area under the receiver operating characteristic curve of 0.87 (95% CI, 0.78–0.95) and a bootstrap optimism-corrected value of 0.82. Higher baseline NLR and lower albumin were associated with all-cause 90-day mortality in this cohort. These exploratory findings do not establish prognostic value independent of anatomical extent or comprehensive clinical severity. Further evaluation and external validation are required before clinical application.