Preoperative Serotonin Antidepressants Are Associated With Increased Postoperative Complications Following Rhinoplasty: A Propensity Score-matched Analysis.

Abstract

Rhinoplasty is a common facial aesthetic procedure. Rhinoplasty's candidates often present with a high prevalence of anxiety and depressive disorders. Serotonergic antidepressants are widely used to manage these disorders. Given recent reports linking these medications to increased postoperative complications, we find it important to assess whether their use carries a higher risk of complications following rhinoplasty. To evaluate the association between preoperative serotonergic antidepressants and the incidence of postoperative complications following rhinoplasty. A retrospective cohort analysis was conducted using the TriNetX Global Collaborative Network. Patients > 18 years who underwent rhinoplasty were divided into two groups: those who had documented serotonergic antidepressants use prior to surgery and those with no history of serotonergic antidepressants use. Propensity score matching (PSM) was applied to balance demographic and clinical variables. Primary outcomes included postoperative complications at three-time intervals: 30 days, 60 days, and 90 days. Secondary outcomes included long-term complications after 1-year. After 1:1 PSM, each cohort consisted of 4,917 patients. Within 30 days following rhinoplasty, patients in the serotonergic cohort had significantly increased risk readmission (RR: 1.793, p=0.01), opioid use (1.361, p<0.0001), and bleeding/hematoma rates (RR: 1.596, p=0.005) compared to control cohort. These risks persisted at 60- and 90-days post-surgery. For long-term outcomes, comparable rates of surgical revision rates were noted after 1-year. Serotonergic antidepressants' use is associated with increased risk for short-term postoperative complications following rhinoplasty surgery.