Impact of Marital Status on Postoperative Outcomes after Endoscopic Endonasal Skull Base Surgery

Objectives: The aim of this study was to examine the relationship between marital status - an important aspect of social support - and postoperative outcomes after endoscopic endonasal approach (EEA) for skull base surgery.

Methods: This was a retrospective analysis of a prospectively collected database. Preliminary review of medical records of 101 adult patients undergoing EEA at a major academic medical center for surgical treatment of anterior skull base pathology (2018–2020) was performed. Patient demographics, comorbidities, complications, and postoperative outcome measures were collected. Patients were categorized into 3 cohorts by marital status at time of surgery (married cohort, n = 52; divorced/separated/widowed cohort, n = 22; single cohort, n = 27).

Results: Baseline characteristics were similar in all relationship groups. Married patients were 77% less likely to miss, cancel, or reschedule postoperative follow-up appointments as compared with all other cohorts (OR: 0.23, 95% CI [0.02, 0.40]). Although there were no significant differences in duration of hospital stay between groups, 45-day readmission rates varied significantly (married 6.9% vs divorced/separated/widowed 15.7% vs. single 22.9%, p = 0.02). Pituitary complications (i.e., SIADH) were more common among non-married patients than married patients (p = 0.03). Rates of re-intervention for post-operative complications, whether surgical or clinical, were also significantly different between groups (married 45% vs. divorced/separated/widowed 72.7% vs. single 74.0%, p = 0.04).

Conclusion: Increased social support appears to be associated with superior short-term and long-term postoperative outcomes among EEA patients for skull base surgery, including decreased readmission rates and need for re-intervention. The added value of marriage among patients may inform prognostic stratification of patients, help identify those at higher risk of adverse outcomes, and guide the design of hospital-based interventions aimed at optimizing recovery. Further data collection and analysis from this prospective cohort is underway.

 

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No conflict of interest has been declared by the author(s).

Publication History

Article published online:
01 February 2023