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.

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

Publication History

Article published online:
01 February 2023