Analyzing the effects of depression among patients with head and neck cancer.

Abstract

e18038 Background: Patients with head and neck cancer carry the prospect of facial disfigurement in addition to the effects on speech, smell, sight, and taste. As such they are at a higher risk of acquiring emotional distress. Despite this, depression is underreported in this population. We review the National Inpatient Sample (NIS) to understand the effects of depression in patients admitted with any diagnosis of head and neck cancer. Methods: We designed a retrospective study and utilized NIS data for the year 2018. We identified patients with any history of Head and Neck cancer using their specific ICD-10 codes. We also identified codes for depressive disorders. Primary outcome was effect of depression on comorbidities. Secondary outcome was hospital length of stay. Utilizing STATA MP 16.1 we performed multivariate logistic regression analysis. Various comorbidities including previous history of coronary artery disease, congestive heart failure, stroke, smoking, hyperlipidemia, and chemotherapy were incorporated into the analysis. Results: The study population included 15,689 patients that were 18 years or older. Mean age was 64 years. Only 28% of the population was females. The mean hospital length of stay was approximately 7 days. In this group of patients, 12% had a history of depression. Among the different types of head and neck cancers oropharyngeal cancers had the highest percentage of depression rates (14%). In multivariable analysis, patients with depression had a higher comorbidity index but this result did not reach statistical significance (Odds Ratio (OR) 1.02, p = 0.054, 95% Confidence Intervals (CI) 0.999 – 1.045). Patients had higher odds of having depression if they also had a history of stroke (OR 1.4, 95% CI 1.13 – 1.73), prior history of chemotherapy (OR 1.25, 95% CI 1.09 – 1.43), history of hyperlipidemia (OR 1.31, 95% CI 1.16 – 1.48) or were admitted over the weekend (OR 1.21, 95% CI 1.07 – 1.38). Younger age was associated with lower odds of depression (OR 0.98, 95% CI 0.98 – 0.99). Women had higher odds of having depression (OR 1.68, 95% CI 1.51 – 1.88). When compared with white people, people from the following demographics had lower odds of depression – Black (OR 0.56, 95% CI 0.47 – 0.68), Hispanic (OR 0.64, 95% CI 0.49 – 0.83), Asian (OR 0.26, 95% CI 0.17 – 0.43), and others (OR 0.53, 95% CI 0.35 – 0.79). Hospital length of stay was higher among patients with depression (OR 0.7, 95% CI 0.2 – 1.15). Conclusions: Among patients with head and neck cancer, odds of having depression are higher in the white population, older patients, females and patients with prior history of chemotherapy. Depression is associated with higher hospital length of stay. These findings help understand the effect of depression on this susceptible population and identify at risk patients for appropriate screening.