Gender as a Predictor of Complications in Endoscopic Sinus Surgery

Background: Understanding patient-specific risk factors for complications of functional endoscopic sinus surgery (ESS) is critical. Previous work has investigated such risk factors, but a population-based analysis has not been performed to date. Objectives: This study analyzes the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database to identify patient-specific risk factors associated with complications following ESS. Methods: A retrospective cohort study of patients who underwent ESS was conducted using the NSQIP database from 2011 to 2017. Patients were identified using CPT-codes for ESS procedures. The primary outcome analyzed was any postoperative complication. Simultaneous procedures with ESS were controlled for with regression analysis. Post-operative complications and 30-day readmission were evaluated using multivariate logistic regression controlling for age, gender, race, comorbidities (diabetes mellitus, hypertension, chronic obstructive pulmonary disease, congestive heart failure, renal failure, steroid use, and cancer history), smoking history, and intraoperative factors. Results: A total of 1279 patients who underwent ESS were identified. The average age of patients was 46.1 (SD = 16.8). Most patients (58.2%) had no major comorbidities. 594 (46.4%) patients had a tonsillectomy, adenoidectomy, or uvulopharyngoplasty at the same time as ESS. 101 (7.9%) patients experienced a complication post-operatively. 46 (3.6%) patients experienced a readmission postoperatively. The most common complication was reoperation (N = 40, 3.1%). Regression analysis revealed that gender was the only demographic factor associated with risk of post-operative complications, with women having a significantly lower risk than men (OR = 0.61, 95% CI 0.37-0.99, P = .046). Conclusions: ESS is typically performed on a relatively young and healthy population. Women have a significantly lower risk of complications after controlling for comorbidities. Further analysis of gender-specific differences in surgical outcomes should be evaluated to understand this phenomenon.

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MP50-20 PATIENT-SPECIFIC RISK FACTORS AND POST-OPERATIVE COMPLICATIONS HAVE A SIGNIFICANT IMPACT ON LONG TERM FUNCTIONAL OUTCOMES FOLLOWING RADICAL PROSTATECTOMY

The Journal of Urology ◽

10.1097/ju.0000000000002076.20 ◽

2021 ◽

Vol 206 (Supplement 3) ◽

Author(s):

Nicholas Raison ◽

Gledisa Musollari ◽

Kathy Man ◽

Natasha Bhate ◽

Joanne Sethi ◽

...

Keyword(s):

Risk Factors ◽

Radical Prostatectomy ◽

Functional Outcomes ◽

Patient Specific ◽

Specific Risk ◽

Operative Complications ◽

Post Operative Complications

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Patient-specific risk factors and post-operative complications have a significant impact on long term functional outcomes following minimally invasive

European Urology ◽

10.1016/s0302-2838(21)01526-8 ◽

2021 ◽

Vol 79 ◽

pp. S1629-S1630

Author(s):

N. Raison ◽

G. Musollari ◽

K. Man ◽

N. Bhate ◽

A. Forde ◽

...

Keyword(s):

Risk Factors ◽

Minimally Invasive ◽

Functional Outcomes ◽

Patient Specific ◽

Specific Risk ◽

Operative Complications ◽

Post Operative Complications

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Cone-beam Computed Tomography Guidance in Functional Endoscopic Sinus Surgery: A Retrospective Cohort Study

Journal of Pharmaceutical Research International ◽

10.9734/jpri/2019/v31i630380 ◽

2020 ◽

pp. 1-7

Author(s):

Hesam Jahandideh ◽

Azam Yarahmadi ◽

Shahin Rajaieh ◽

Amin Ostvar Shirazi ◽

Maryam Milanifard ◽

...

Keyword(s):

Computed Tomography ◽

Image Quality ◽

Endoscopic Sinus Surgery ◽

Functional Endoscopic Sinus Surgery ◽

Sinus Surgery ◽

Cone Beam ◽

Image Guided ◽

Operative Complications ◽

The Mean ◽

Post Operative Complications

Introduction: Using image-guided intra-operative navigation systems in surgeries like functional endoscopic sinus surgery (FESS) has become widely accepted as an effective tool for improvement of surgical outcomes and reduction of complication. Cone-beam CT (CBCT) is a variant of computed tomography imaging that has developed as a cross-sectional and potentially low-dose technique to visualize bony structures in the head and neck. In current study, it was tried to evaluate surgeons’ satisfaction with CBCT intra-operative navigation imaging as well as image quality prior to FESS and post-operative complications. Methods: In this prospective study, the included patients who were candidates for FESS underwent CBCT from January to June 2019. The data regarding demographic information, CBCT findings and diagnosis were extracted. The surgeons’ satisfaction with intra-operative navigation imaging and image quality was quantified using Visual Analogue Scale (VAS) (ranging 0 – 10). Furthermore, patients were contacted 3 months later to ask for their satisfaction with the operation using VAS and post-operative complications evaluated. Results: Totally, 39 patients were included. The mean age was 40.74±5.75 and 20 patients (51.28 percent) were male. Two surgeons performed this operation separately; one of the surgeons performed 20 (51.28 percent) FESS and the other performed 19 (48.71 percent). The mean satisfaction of the surgeons of CBCT guided FFESS was 8.69±0.92. After the 3-month follow up, patients’ satisfaction score was 8.21±1.89. No postoperative complications were reported. Conclusion: Based on the surgeons’ point of view, CBCT was shown to be reliable for image-guided FFESS. Furthermore, the outcome and complications of performed surgeries were similar to those performed with computed tomography intra-operative navigation imaging.

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Risk Factors for Failure in Conservatively Treated Osteoporotic Vertebral Fractures: A Systematic Review

Global Spine Journal ◽

10.1177/2192568220982279 ◽

2021 ◽

pp. 219256822098227

Author(s):

Max J. Scheyerer ◽

Ulrich J. A. Spiegl ◽

Sebastian Grueninger ◽

Frank Hartmann ◽

Sebastian Katscher ◽

...

Keyword(s):

Risk Factors ◽

Systematic Review ◽

Treatment Failure ◽

Patient Specific ◽

Mineral Density ◽

Radiographic Findings ◽

Specific Risk ◽

Fracture Development ◽

Predict Treatment Failure

Study Design: Systematic review. Objectives: Osteoporosis is one of the most common diseases of the elderly, whereby vertebral body fractures are in many cases the first manifestation. Even today, the consequences for patients are underestimated. Therefore, early identification of therapy failures is essential. In this context, the aim of the present systematic review was to evaluate the current literature with respect to clinical and radiographic findings that might predict treatment failure. Methods: We conducted a comprehensive, systematic review of the literature according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) checklist and algorithm. Results: After the literature search, 724 potentially eligible investigations were identified. In total, 24 studies with 3044 participants and a mean follow-up of 11 months (range 6-27.5 months) were included. Patient-specific risk factors were age >73 years, bone mineral density with a t-score <−2.95, BMI >23 and a modified frailty index >2.5. The following radiological and fracture-specific risk factors could be identified: involvement of the posterior wall, initial height loss, midportion type fracture, development of an intravertebral cleft, fracture at the thoracolumbar junction, fracture involvement of both endplates, different morphological types of fractures, and specific MRI findings. Further, a correlation between sagittal spinal imbalance and treatment failure could be demonstrated. Conclusion: In conclusion, this systematic review identified various factors that predict treatment failure in conservatively treated osteoporotic fractures. In these cases, additional treatment options and surgical treatment strategies should be considered in addition to follow-up examinations.

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Effects of Age on Recovery of Olfactory Function After Endoscopic Sinus Surgery and Related Risk Factors

Ear Nose & Throat Journal ◽

10.1177/01455613211012927 ◽

2021 ◽

pp. 014556132110129

Author(s):

Weiping Qi ◽

Liang Feng ◽

Fengyan Yang ◽

Weihuan Ma

Keyword(s):

Risk Factors ◽

Allergic Rhinitis ◽

Endoscopic Sinus Surgery ◽

Nasal Polyps ◽

Protective Factor ◽

Olfactory Function ◽

Sinus Surgery ◽

The Poor ◽

Related Risk ◽

Good Improvement

Objectives: To study the effects of age on the olfactory function recovery of chronic rhinosinusitis patients after endoscopic sinus surgery and related risk factors. Methods: A total of 176 chronic rhinosinusitis (CRS) patients enrolled from February 2017 to October 2019 were divided into child, youth, middle-aged, and elderly groups. Their baseline data, T&T olfactory test score, visual analogue scale (VAS) olfactory score, sinus computed tomography (CT) Lund-Mackay score, and Lund-Kennedy score were compared. Based on postoperative olfactory function, they were divided into good and poor improvement groups. Results: Complication with nasal polyps, allergic rhinitis history, and sinus surgery history had significant differences among patients of different ages ( P < .05). Three months after surgery, T&T olfactory, VAS olfactory, Lund-Mackay, and Lund-Kennedy scores all rose with increasing age, with significant differences between any 2 groups ( P < .05). The improvement of postoperative olfactory function became poorer with aging ( P < .05). T&T and VAS olfactory scores had significant positive correlations with Lund-Mackay and Lund-Kennedy scores ( P < .001). Age, preoperative Lund-Mackay and Lund-Kennedy scores, complication with nasal polyps, allergic rhinitis history, sinus surgery history, and postoperative complications were risk factors for the poor improvement of postoperative olfactory function. Doctor-directed treatment was a protective factor for good improvement. Conclusions: The improvement of olfactory function of CRS patients after endoscopic sinus surgery declines with aging. Age, preoperative Lund-Mackay and Lund-Kennedy scores, complication with nasal polyps, allergic rhinitis history, sinus surgery history, and postoperative complications are risk factors for the poor improvement of postoperative olfactory function. Doctor-directed treatment is a protective factor for good improvement.

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