Depression and hospital admission in older patients with head and neck cancer: analysis of a national healthcare database.

OBJECTIVES: The aim the study was to determine whether the presence of depression was associated with an increased likelihood of hospital admission among adult patients 50 years and over diagnosed with head and neck cancer (HNC) visiting emergency departments (EDs) in the United States.

BACKGROUND: Head and neck cancer is associated with high morbidity and mortality. In patients with cancer, depression is predictive of increased mortality and the effect remains after adjusting for comorbidities. Patients with cancer who are depressed are less likely to participate in treatment decisions and to seek social support which can lead to worsening overall health outcomes among patients with HNC.

MATERIALS AND METHODS: We performed secondary analysis of data from the Nationwide Emergency Department Sample (NEDS) in the United States using multivariable Poisson regression to estimate prevalence ratios (PRs) and 95% confidence intervals (CIs). We included adults aged 50 years and older, diagnosed with HNC using International Classification of Diseases, 9th revision (ICD-9-CM) codes. We controlled for demographic, clinical and hospital characteristics in the multivariable models.

RESULTS: In the final multivariable model for adults 50 years and over, male HNC patients with depression were 28% (CI = 21-36%) more likely to be admitted following an ED visit and female HNC patients with depression were 31% (CI = 20-42%) more likely to be admitted. In stratified analysis, the association was strongest for males with specific HNC of the oral cavity who were 56% (CI = 25-94%) more likely to be admitted.

CONCLUSION: Depression is associated with hospital admission among adults aged 50 and over with HNC.