- Design
- Propensity-matched retrospective database cohort
- Population
- About 5,000 patients per group having septoplasty with turbinoplasty
- Primary outcome
- Postoperative complications and healthcare use
- Effect
- Without depression/anxiety: ED visits OR 0.52, readmission OR 0.55, epistaxis OR 0.70
This propensity-matched TriNetX database study compared patients having septoplasty with turbinoplasty with and without depression or anxiety (about 5,000 per group), and also treated with untreated depression or anxiety.
Patients without depression or anxiety had lower odds of epistaxis (OR 0.70), sinusitis (OR 0.62), emergency department visits (OR 0.52), readmission (OR 0.55) and opioid prescription (OR 0.77). Comparing untreated with medication-treated depression or anxiety gave mixed results: higher odds of epistaxis (OR 3.94) but lower readmission (OR 0.38) and opioid prescribing (OR 0.69) in the untreated group.
The main signal is that patients with depression or anxiety use more post-operative care after a common elective nasal operation. The treated-versus-untreated comparison is hard to interpret — antidepressants such as SSRIs affect platelet function, and treated patients may simply have more severe illness — so it does not tell you whether treating mood disorders improves outcomes. Database coding limits all of these estimates.
- Ask about depression, anxiety and current antidepressants when consenting for septoplasty.
- Set expectations about recovery and give a clear contact route to reduce unplanned ED visits.
- Check for SSRI or SNRI use when planning haemostasis, given their effect on platelet function.
- Do not delay surgery to start psychiatric treatment on the basis of this study; it cannot show benefit.
Why it matters
It identifies a group likely to return to the ED after a routine day-case nasal operation.
Don't overread it
Database associations; the treated-versus-untreated findings are confounded and do not show that treatment changes outcomes.
The statistics, in plain English
An odds ratio of 0.52 for ED visits means the odds were about half in patients without depression or anxiety. Matching on recorded factors cannot remove differences in how often patients seek care, which is itself linked to anxiety.
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