Predictors of Perioperative Patient Communications in Endoscopic Sinus Surgery

To assess the prevalence and reasons for patient-initiated communications (PIC) in the perioperative period for outpatient endoscopic sinus surgery (ESS) and identify patient or surgical factors associated with increased PIC.

Retrospective chart review at a single tertiary care center performing outpatient endoscopic sinus surgery between January 1, 2023 and December 31, 2023. Patient demographics, surgical characteristics, frequency of PIC, and reasons for perioperative PIC were recorded. The average number of communications, as well as the likelihood of engaging in PIC, were compared between patient, and surgical characteristics.

A total of 167 patient charts were reviewed, among which 98 patients (59%) generated 149 PICs. Patients were 51% male, 33% had a smoking history, and 30% had a history of anxiety/depression. Most (84%) underwent primary surgery. Gender (OR 1.22; 95% CI 0.53-2.8) and smoking history (OR 1.80; 95% CI 0.71-4.7) were not associated with higher PIC frequency. PICs were more likely among patients with anxiety/depression (OR 11.9; 95% CI 4.0-35) and those who received nasal septal splints (OR 2.59; 95% CI 1.08-6.23). Preoperative PICs most commonly involved scheduling and recovery questions, while postoperative PICs were primarily related to nasal obstruction and epistaxis.

Perioperative PIC is frequent among ESS patients, particularly those with anxiety/depression or nasal splints. Understanding the most common communication triggers may guide quality improvement initiatives to pre-emptively address these concerns.