- Design
- Retrospective propensity-matched database cohort
- Population
- Adults having septoplasty with turbinoplasty; 5,012 matched pairs
- Primary outcome
- Postoperative complications and health care use
- Effect
- Without depression/anxiety: ED visits OR 0.52, readmission OR 0.55, epistaxis OR 0.70
This propensity-matched database study compared outcomes after septoplasty with turbinoplasty in patients with and without depression or anxiety, and between those whose condition was or was not treated with medication.
In 5,012 matched pairs, patients without depression or anxiety had lower odds of epistaxis (OR 0.70), sinusitis (OR 0.62), emergency 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: more epistaxis but fewer readmissions and opioid prescriptions in the untreated group.
Coded diagnoses, unmeasured confounding and contact with health services all affect these results; people with recorded depression may simply seek care more readily. The mixed findings for treatment do not support any conclusion about whether treating depression changes surgical outcomes.
The useful point is to recognise a group with higher post-operative contact and to prepare them for recovery.
- Ask about depression and anxiety when consenting for septoplasty.
- Give clear written aftercare and a contact route to reduce unplanned emergency visits.
- Plan non-opioid analgesia as the default after septoplasty.
- Do not delay surgery to start antidepressants on the basis of this study.
Why it matters
Unplanned returns after a routine nasal operation are partly predictable from history.
Don't overread it
This database study shows association only and cannot say whether treating depression or anxiety improves surgical outcomes.
The statistics, in plain English
Propensity matching balances recorded characteristics, but not how often people seek care, which may explain part of the excess. The treated-versus-untreated results point in different directions and should not be over-read.
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