Clinical and Socioeconomic Predictors of 60-Day Rehospitalization After Oncologic Head and Neck Surgery.

Abstract

Evaluate the association between clinical characteristics and neighborhood socioeconomic disadvantage and 60-day re-presentation after oncologic head and neck surgery. This retrospective cohort study involved 1,088 patients who underwent oncologic head and neck surgery from August 2012 to November 2024. Tertiary academic center. The main outcome measure was 60-day Emergency Department (ED) visit or readmission after primary hospital discharge following surgery. Patient demographics, clinical characteristics, and neighborhood socioeconomic disadvantage, as measured by state-level area deprivation index (ADI). Predictors of re-presentation within 60 days of discharge on univariate analysis include tumor stage 4 (OR: 1.52, 95% Cl: 1.01-2.31, P = .044), longer primary length of stay (OR: 1.03, 95% Cl: 1.01-1.05, P < .001), and residency in the 4th quartile state ADI (OR: 1.54, 95% Cl: 1.03-2.31, P = .037). Multivariable logistic regression identified laryngeal cancer (OR: 1.60, 95% Cl: 1.16-2.21, 0.004) and discharge with home health or other care facilities (2.22, 95% Cl: 1.67-2.96, P < .001) as predictive factors. Patients from low ADI neighborhoods (Q1-3) were more likely to be discharged home, whereas those from high ADI neighborhoods (Q4) where almost twice as likely to be discharged with home health or to care facilities than home alone (18.70% vs 10.29%, P = < .001). Our study demonstrates that clinical and systemic factors contribute to re-presentation to the hospital after major oncologic head and neck surgery. Addressing these factors through targeted policies and institutional initiatives may help mitigate the morbidity and cost associated with representation.