Abstract
Objectives:
The incidence of depressive symptoms in head and neck cancer (HNC) patients has been shown to be up to 40% during treatment and can affect patients’ desires to rehabilitate after surgery. The objectives in this study were to (1) evaluate the relationship between preoperative depressive symptoms and postoperative functional performance status (PFPS) and (2) assess the effect of preoperative depressive symptoms on length of hospital stay (LOHS), completion of adjuvant therapy (CAT), rate of postoperative readmission, and loss of follow-up.
Methods:
A prospective cohort study was conducted in new adult HNC patients undergoing surgery as primary therapy from January 2013 to January 2014 measuring baseline preoperative depressive symptomatology on the Quick Inventory of Depressive Symptomatology (QIDS) and PFPS was assessed on the Functional Assessment of Cancer Therapy-Head & Neck (FACT-HN) 6 months from the initial presentation. Secondary outcomes assessed included LOHS, CAT, rate of readmission due to failure to thrive, and loss of follow-up. A Mann-Whitney U test and chi-squared analyses were used to assess the difference between the Normal-Mild and Moderate-Severe QIDS groups.
Results:
Preliminary results of the prospective study demonstrate an incidence of preoperative moderate-severe depression of 29.2% and significant difference in FACT-HN scores between moderate-severely depressed patients and those with normal-mild symptoms (P = .03). CAT scores trended to lower in the MS group (P = .09), but there was no significant difference in loss of follow-up (P = .24).
Conclusions:
Depression should be recognized as a contributive factor in postoperative functional performance status.
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