Depression or anxiety was linked to more complications after septoplasty with turbinoplasty

Design

Retrospective propensity-matched cohort, TriNetX Research Network

Population

About 5,000 patients per group after septoplasty with turbinoplasty

Primary outcome

Postoperative anosmia, epistaxis, opioid prescription, ED visits, sinusitis, readmission, septal perforation

Effect

No depression or anxiety: epistaxis OR 0.70, sinusitis 0.62, ED visits 0.52, readmission 0.55

This TriNetX cohort used propensity-matched groups of about 5,000 patients each who had septoplasty with turbinoplasty. People without depression or anxiety were compared with those with it.

Those without depression or anxiety had lower odds of epistaxis (OR 0.70), sinusitis (0.62), emergency department visits (0.52), readmission (0.55) and opioid prescription (0.77). Among patients with depression or anxiety, those who were untreated had higher odds of epistaxis (OR 3.94) than those treated with medication, but lower odds of readmission (0.38) and opioid prescription (0.69). That mixed picture suggests the grouping may reflect differences in the patients and in how the data record treatment.

The authors call for studies of whether treating the mood disorder changes surgical outcomes. For now, the finding supports asking about mood before elective nasal surgery and counselling accordingly.

• Ask about depression and anxiety before septoplasty and turbinoplasty.
• Counsel patients with these conditions about a higher chance of bleeding, sinusitis and return visits.
• Plan postoperative analgesia carefully, since opioid prescribing was higher.
• Do not delay surgery on this basis alone; the study does not show that treatment changes outcomes.

Why it matters

Mood is a readily available predictor of who returns after routine nasal surgery.

Don't overread it

A retrospective database study; the treated-versus-untreated comparison gave conflicting results and cannot show that treatment prevents complications.

The statistics, in plain English

Matching balances the measured characteristics, but not unmeasured ones such as symptom severity or health behaviour. Large database cohorts make small differences significant, so each odds ratio should be read for size as well as P value.

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