Clinical and psychosocial variables influencing preoperative anxiety in patients undergoing sinus surgery

To explore the association between preoperative anxiety and nasal-specific symptoms in patients undergoing sinus surgery.

A retrospective review was conducted on 150 patients who underwent routine sinus surgery between January 2022 and June 2025. All participants completed the Self-Rating Anxiety Scale (SAS), the 22-Item Sino-Nasal Outcome Test (SNOT-22), and the Family Adaptation, Partnership, Growth, Affection, and Resolve (APGAR) Index. Feature selection was performed using LASSO regression, followed by multivariate logistic regression to identify independent predictors of preoperative anxiety. A predictive nomogram was constructed and internally validated using the Bootstrap method. The model's performance was evaluated using ROC curves, calibration curves, and decision curve analysis (DCA).

Patients in the anxiety group had significantly higher mean ages, Lund-Mackay scores, and SNOT-22 total scores, but lower monthly household income per capita and APGAR scores compared to the non-anxiety group. LASSO regression identified age, endotracheal intubation, Lund-Mackay score, monthly household income, SNOT-22, and APGAR as candidate predictors. Multivariate logistic regression confirmed that age, Lund-Mackay score, monthly household income, SNOT-22and APGAR were independent predictors of preoperative anxiety. The nomogram showed good discrimination, calibration, and clinical utility. Correlation analysis revealed that the SAS score was positively correlated with the SNOT-22 score and negatively correlated with the APGAR score.

More severe nasal-specific symptoms and lower family support were associated with a higher risk of preoperative anxiety in patients undergoing sinus surgery. Age, Lund-Mackay score, monthly household income, SNOT-22, and APGAR were independent predictors, providing a reference for individualized anxiety intervention in clinical practice.