Clinical and psychosocial variables influencing preoperative anxiety in patients undergoing sinus surgery

OBJECTIVE: To explore the association between preoperative anxiety and nasal-specific symptoms in patients undergoing sinus surgery. METHODS: A retrospective review was conducted on 150 patients who underwent routine sinus surgery between January 2022 and June 2025. All participants completed the Self-Rating Anxiety Scale (SAS), the 22-Item Sino-Nasal Outcome Test (SNOT-22), and the Family Adaptation, Partnership, Growth, Affection, and Resolve (APGAR) Index. Feature selection was performed using LASSO regression, followed by multivariate logistic regression to identify independent predictors of preoperative anxiety. A predictive nomogram was constructed and internally validated using the Bootstrap method. The model's performance was evaluated using ROC curves, calibration curves, and decision curve analysis (DCA). RESULTS: Patients in the anxiety group had significantly higher mean ages, Lund-Mackay scores, and SNOT-22 total scores, but lower monthly household income per capita and APGAR scores compared to the non-anxiety group. LASSO regression identified age, endotracheal intubation, Lund-Mackay score, monthly household income, SNOT-22, and APGAR as candidate predictors. Multivariate logistic regression confirmed that age, Lund-Mackay score, monthly household income, SNOT-22and APGAR were independent predictors of preoperative anxiety. The nomogram showed good discrimination, calibration, and clinical utility. Correlation analysis revealed that the SAS score was positively correlated with the SNOT-22 score and negatively correlated with the APGAR score. CONCLUSIONS: More severe nasal-specific symptoms and lower family support were associated with a higher risk of preoperative anxiety in patients undergoing sinus surgery. Age, Lund-Mackay score, monthly household income, SNOT-22, and APGAR were independent predictors, providing a reference for individualized anxiety intervention in clinical practice.