(1240) Impact of Iron Deficiency Anemia on Postoperative Outcomes Following Septoplasty: A Multi-Institutional Matched Cohort Study

Introduction: Iron deficiency anemia (IDA) is a common systemic condition that may impair physiologic reserve and perioperative recovery. This study evaluated whether preoperative IDA is associated with increased postoperative complications following septoplasty.

Methods: A retrospective cohort analysis representing electronic health records from 113 healthcare organizations was performed using the TriNetX Research Network. Adults aged 18-89 undergoing CPT-coded septoplasty were included. Cohort A had a diagnosis of IDA within 13 months prior to septoplasty, while Cohort B had no IDA diagnosis. Outcomes were assessed from postoperative day 1 through 365 and included nasal perforation, anosmia, snoring, and emergency department (ED) visits. Propensity score matching (1:1) was performed on demographics, comorbidities (diabetes mellitus, sleep apnea, chronic sinusitis, chronic rhinitis, nasal polyps, and deviated nasal septum), and BMI, yielding 2,021 patients per cohort.

Results: After matching, IDA patients demonstrated higher risks of nasal perforation (6.7% vs 5.4%; RR 1.25; p = 0.075) and snoring (5.4% vs 4.1%; RR 1.31; p = 0.055), though these did not reach statistical significance. Anosmia rates were similar between groups (1.1% vs 1.0%; p = 0.646). ED visits were significantly higher in the IDA cohort (22.9% vs 13.7%; RR 1.67; p < 0.001).

Conclusions: Preoperative IDA was not associated with significantly increased rates of septoplasty-specific complications but was strongly associated with higher postoperative ED utilization. These findings suggest that while IDA may not directly worsen surgical site outcomes, it may contribute to increased postoperative healthcare utilization, highlighting the importance of perioperative optimization and follow-up in this population.