Association of preoperative depression and clinical outcomes after head and neck free flap reconstruction
Otolaryngology–Head and Neck Surgery, 2026
In this cohort of 645 patients undergoing head and neck free flap reconstruction, preoperative depression was identified in 158 patients (24%) and antidepressant use in 150 (23%). Preoperative depression was not associated with overall survival or differences in length of stay or 30-day readmissions, but antidepressant use was linked to increased likelihood of discharge to rehabilitation or skilled nursing facilities (adjusted odds ratio: 1.82, 95% Confidence Interval: 1.07-3.06). Among patients receiving adjuvant radiation, preoperative depression was associated with decreased risk of treatment delay (aOR: 0.48, 95% CI: 0.23‐0.99). These findings highlight the complex relationship between mental health and surgical recovery and support improved preoperative screening and multidisciplinary care for patients undergoing complex oncologic reconstruction.
Recommended citation: Sridhar S, Larson DP, Suh H, Swain BB, Habib DRS, Vittetoe K, Sengstack D, Topf MC, Hicks MD. Association of preoperative depression and clinical outcomes after head and neck free flap reconstruction. Otolaryngol Head Neck Surg. 2026. doi:10.1002/ohn.70220