(1200) 10-Year Trends in Functional Endoscopic Sinus Surgery and 30-Day Outcomes: A 2011-2021 NSQIP Database Study

Introduction: Functional endoscopic sinus surgery (FESS) is a cornerstone treatment for chronic rhinosinusitis and related sinonasal disease. Understanding national trends in patient complexity and outcomes for isolated FESS procedures may inform evolving surgical practice.

Methods: ACS NSQIP Participant Use Files from 2011–2021 were analyzed. FESS cases were identified using CPT codes (31254–31259, 31267, 31276, 31287–31288). Temporal trends in patient demographics, comorbidities, operative characteristics, and 30-day postoperative outcomes were assessed using linear regression. Unadjusted complication-risk modeling was performed to examine associations between the aforementioned variables and 30-day postoperative complications. Temporal variation in selected risk associations was assessed using year×predictor interaction terms. Statistical significance was defined as p< 0.05.

Results: A total of 749 FESS cases were identified. Mean patient age (0.54 years/year, p=0.013) and operation time (6.54 minutes/year, p=0.033) increased. Reductions were observed in postoperative pneumonia (−0.30 percentage points/year, p=0.011) and wound infection (−0.38 percentage points/year, p=0.025). In contrast, wound disruption and dehiscence increased modestly (+0.15 percentage points/year, p=0.029).
In complication-risk modeling, older age, higher ASA class, diabetes, inpatient status, and longer operative time were associated with increased 30-day complications (unadjusted p< 0.05). Association with Hispanic ethnicity, weight, and estimated mortality risk varied significantly (year×predictor p< 0.05).

Conclusions: From 2011 to 2021, FESS cases demonstrated increasing patient age and operative time. Several postoperative complications, including pneumonia and wound infection, declined over time, while wound disruption and dehiscence increased modestly. In complication-risk modeling, patient comorbidity burden, operative factors, and functional status were associated with 30-day postoperative complications, with selected risk associations varying.