FACTORS IMPACTING POST OP HEMORRHAGE IN ENDOSCOPY SINUS SURGERY

Abstract

OBJECTIVE: To determine the factors impacting post op hemorrhage in endoscopy sinus surgery

STUDY DESIGN: Prospective cohort study

PLACE AND DURATION: CMH Peshawar from June 2024-Nov 2024

METHODOLOGY: This Prospective cohort study collected demographic and clinical data, including age, gender, smoking status, anticoagulant use, Lund–Mackay score, and surgical details. All patients underwent ENT examination, nasal endoscopy, and CT imaging before endoscopic sinus surgery (ESS), performed under general anesthesia using the standard approach. Postoperative bleeding was defined as hemorrhage within 30 days requiring intervention. Data were analyzed using SPSS 21 with descriptive statistics and logistic regression. Variables significant in univariate analysis (p < 0.10) were included in multivariate analysis to identify independent predictors of postoperative bleeding (p < 0.05).

RESULTS: Among 234 patients, 142 (60.7%) were male and 92 (39.3%) female, with mean ages of 41.36±16.86 and 43.00±17.94 years, respectively. Postoperative bleeding was significantly associated with prior sinonasal surgery (p=0.002), anticoagulant use (p=0.001), hypertension (p=0.015), and Lund–Mackay CT score ≥15 (p=0.003). Other factors, including age, gender, diabetes, BMI, smoking, and allergic rhinitis, showed no significant associations.

CONCLUSIONS: In conclusion, postoperative hemorrhage remains one of the frequent complications following endoscopic sinus surgery. The major factors associated with increased bleeding risk include the use of antiplatelet or anticoagulant medications, elevated blood pressure, and higher Lund–Mackay CT scores.