{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T12:52:30Z","timestamp":1791982350404,"version":"4.4.0"},"reference-count":29,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T00:00:00Z","timestamp":1777852800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T00:00:00Z","timestamp":1777852800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Head &amp; Neck"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Depression and anxiety are common in patients with head and neck cancer (HNC), but their impacts on postoperative outcomes after major HNC surgery are not well defined. We evaluated whether preexisting, clinically diagnosed depression or anxiety independently predicted short\u2010term postoperative outcomes among adults undergoing HNC resection.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We performed a retrospective cohort study using 100% Medicare Standard Analytic Files from 2016 to 2023. Beneficiaries with HNC who underwent oncologic head and neck resection were identified using ICD\u201010\u2010CM\/PCS codes. Preexisting depression and anxiety were defined using Chronic Conditions Warehouse algorithms (\u2265\u20091 inpatient or \u2265\u20092 outpatient claims in the year before surgery). Outcomes included length of stay (LOS), extended LOS (&gt;\u200975th percentile), in\u2010hospital complications, and 30\u2010 and 90\u2010day readmission and mortality. LOS was modeled using truncated negative binomial regression; binary outcomes were modeled with multivariable logistic regression adjusting for demographics, comorbidities, tumor site, tobacco use, hospital teaching status, procedure complexity, and co\u2010occurring depression or anxiety.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 45\u2009293 patients (median age 72\u2009years), 6.6% had preexisting depression and 7.6% had preexisting anxiety. Depression was associated with a longer LOS (incidence rate ratio [IRR] 1.06, 95% CI 1.07\u20131.13), higher 30\u2010day mortality (odds ratio [OR] 1.28, 95% CI 1.06\u20131.54), 90\u2010day mortality (OR 1.22, 95% CI 1.07\u20131.39), and higher 30\u2010 and 90\u2010day readmissions (OR 1.20, 95% CI 1.07\u20131.34; OR 1.27, 95% CI 1.15\u20131.39), but not with in\u2010hospital complications. Anxiety was similarly associated with longer LOS (IRR 1.10, 95% CI 1.07\u20131.13), extended LOS (OR 1.33, 95% CI 1.20\u20131.48), in\u2010hospital complications (OR 1.18, 95% CI 1.06\u20131.30), and higher 30\u2010 and 90\u2010day mortality (OR 1.38, 95% CI 1.16\u20131.65; OR 1.33, 95% CI 1.18\u20131.50), but not readmissions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Among Medicare beneficiaries undergoing HNC surgery, preexisting depression or anxiety are independent markers of increased postoperative risk. Routine mental health screening and targeted perioperative support may be important components of high\u2010quality head and neck oncologic care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/hed.70307","type":"journal-article","created":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T05:55:14Z","timestamp":1777960514000},"page":"2830-2836","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Associations Between Preexisting Depression and Anxiety and Postoperative Outcomes Among Medicare Beneficiaries Undergoing Head and Neck Cancer Surgery"],"prefix":"10.1002","volume":"48","author":[{"given":"Xiaodan","family":"Hu","sequence":"first","affiliation":[{"name":"The Center for the Advancement of Team Science, Analytics, and Systems Thinking in Health Services and Implementation Science Research (CATALYST)  Columbus Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Gilmore","sequence":"additional","affiliation":[{"name":"The Center for the Advancement of Team Science, Analytics, and Systems Thinking in Health Services and Implementation Science Research (CATALYST)  Columbus Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ericka L.","family":"Erickson","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology \u2013 Head &amp; Neck Surgery The Ohio State University College of Medicine  Columbus Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9317-6536","authenticated-orcid":false,"given":"Catherine T.","family":"Haring","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology \u2013 Head &amp; Neck Surgery The Ohio State University College of Medicine  Columbus Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyle","family":"VanKoevering","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology \u2013 Head &amp; Neck Surgery The Ohio State University College of Medicine  Columbus Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nolan B.","family":"Seim","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology \u2013 Head &amp; Neck Surgery The Ohio State University College of Medicine  Columbus Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen Y.","family":"Kang","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology \u2013 Head &amp; Neck Surgery The Ohio State University College of Medicine  Columbus Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James W.","family":"Rocco","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology \u2013 Head &amp; Neck Surgery The Ohio State University College of Medicine  Columbus Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ann Scheck","family":"McAlearney","sequence":"additional","affiliation":[{"name":"The Center for the Advancement of Team Science, Analytics, and Systems Thinking in Health Services and Implementation Science Research (CATALYST)  Columbus Ohio USA"},{"name":"Department of Family and Community Medicine The Ohio State University College of Medicine  Columbus Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5458-0544","authenticated-orcid":false,"given":"Lauren E.","family":"Miller","sequence":"additional","affiliation":[{"name":"The Center for the Advancement of Team Science, Analytics, and Systems Thinking in Health Services and Implementation Science Research (CATALYST)  Columbus Ohio USA"},{"name":"Department of Otolaryngology \u2013 Head &amp; Neck Surgery The Ohio State University College of Medicine  Columbus Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,5,4]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/pon.3409"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(11)70002-X"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291709992285"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.24561"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12885-019-6181-4"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/ecc.13086"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoto.2015.3171"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoto.2013.4072"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/pon.4893"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.31675"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoto.2021.1728"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0006-3223(03)00566-3"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/pon.5058"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00520-025-09847-2"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoto.2024.3233"},{"key":"e_1_2_8_17_1","unstructured":"Chronic Conditions Data Warehouse \u201cOther Chronic Health Mental Health and Potentially Disabling Conditions \u201daccessed November 26 2025 https:\/\/www2.ccwdata.org\/web\/guest\/condition\u2010categories\u2010other."},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-021-09838-7"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12888-018-1990-6"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2019.09.048"},{"issue":"12","key":"e_1_2_8_21_1","article-title":"Challenges and Solutions in Postoperative Complications: A Narrative Review in General Surgery","volume":"15","author":"Javed H.","year":"2023","journal-title":"Cureus"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005650-199407000-00004"},{"key":"e_1_2_8_23_1","unstructured":"Comorbidity SAS Macro (2021 version) \u201cNational Cancer Institute \u201dUpdated 2021 accessed December 3 2025 https:\/\/healthcaredelivery.cancer.gov\/seermedicare\/considerations\/macro\u20102021.html."},{"key":"e_1_2_8_24_1","unstructured":"National Cancer Institute. 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