(1205) Age and Diabetes as Predictors of Endoscopic Sinus Surgery Complication

Introduction: Endoscopic sinus surgery (ESS) is a safe procedure for treating a range of inflammatory and neoplastic conditions. While uncommon, complications of ESS include bleeding, infection, eye injury, and cerebrospinal fluid leak. Previous literature has identified male gender and medical comorbidities as increasing the risk of ESS complication, however the role of age as a predictor of complication has not been reported.

Methods: Using the NIH’s All of Us database, a retrospective cohort study analyzed U.S. patients who underwent ESS for chronic rhinosinusitis. Patients were stratified by gender, age, race, ethnicity, BMI, income level, education, and medical comorbidities: diabetes, heart disease, hypertension and coagulopathy. The primary outcome was the development of a postprocedural complication, defined as a new diagnosis of complication within 30 days of surgery. Logistic regression was used to adjust the odds ratio.

Results: 857 patients (ages 10-86) underwent 1085 ESS for chronic rhinosinusitis with 47 (4.3%) complications reported. The most common complications were infectious and hemorrhagic. When controlling for gender, race, ethnicity, BMI, income, education, and medical comorbidity, age was found to be an independent predictor of complication development with a 4.6% increase in risk of complication per 10-year increase in age (Odds Ratio: 1.046, 95% Confidence Interval: [1.007, 1.086], p = 0.021). Diabetes was also significantly associated with complication (2.833 [1.141 - 7.031], p = 0.025). No other variables were significant.

Conclusions: Increasing age appears to be an independent risk factor for complication following ESS for chronic rhinosinusitis. Further research is needed to confirm and identify the potential causes of the observed trend.