Author(s)
Sherron Thomas, BSA
Helen Shi, BS
LeeAnna Lui, BS
Emily Hunt, BS
Christina H. Fang, MD
Affiliation(s)
Albert Einstein College of Medicine;
Abstract:
Background: Many elective cases of endoscopic sinus surgery (ESS) for chronic rhinosinusitis were delayed during the COVID-19 pandemic. ESS posed a unique concern due to the potential of aerosolized transmission of SARS-Cov-2 particles originating in the upper airway. We aim to study the impact of the COVID-19 pandemic on case volume and outcomes of ESS.
Study Design: This cross-sectional study encompassed all elective cases of ESS between 2017-2020, utilizing data from the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database. Patient demographics and postoperative outcomes were compared from 2020 to the years preceding the pandemic using univariate analysis.
Results: ESS case volume decreased by 20.0% from 2019 to 2020. There was a significant increase in the age of patients in 2020 compared to preceding years (IQR: 32-61 vs. 36-66 years, p = 0.041). There was a significant decrease in outpatient cases and a significant increase in inpatient cases (67.6% vs. 50.0%, 32.4% vs 50.0%, p < 0.001). There were greater occurrences of postoperative deep vein thrombosis (DVT) and thrombophlebitis (0.0% vs 0.9%, p = 0.025). No significant differences were observed in comorbidities, American Association of Anesthesiology classification, surgical complications, and postoperative 30-day outcomes following the onset of the pandemic.
Conclusions: There was an expected decrease in elective ESS cases during the COVID-19 pandemic. The significant increase in the occurrence of DVT and thrombophlebitis suggests a possible need for increased vascular screening in the context of COVID-19 prevalence. This study reinforces the idea that ESS continues to be a generally safe surgical procedure.