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Video

Head and Neck Surgery

(A633) Social Determinants of Health and Discharge Characteristics in Head and Neck Free Flap Reconstruction

Monday, October 13, 2025
12:00 PM - 1:00 PM EDT
Location: OTO EXPO, Posters

    Presenting Author(s)

  • AK

    Alexander Karabachev, MD

    Resident
    University of Cincinnati MedicalCenter/College of Medicine
    Cincinnati, Ohio, United States

    • Co-Author(s)

  • EW

    Eric Wong, BS

    Medical Student
    University of Cincinnati College of Medicine, United States

  • ST

    Siddhant Tripathi, MD

    University of Cincinnati MedicalCenter/College of Medicine, United States

  • MB

    Madelyn Bell, BSN

    University of Cincinnati, United States

  • Adam Beucler, BS

    Medical Student
    University of Cincinnati College of Medicine
    Hudson, Ohio, United States

  • JG

    Jack Garcia, BS

    Medical Student
    University of Cincinnati College of Medicine, United States

  • Christine Lee, BA, MPH

    Medical Student
    University of Cincinnati College of Medicine
    Cincinnati, Ohio, United States

  • Emma Nienaber, BS

    Medical Student
    University of Cincinnati College of Medicine
    Erlanger, Kentucky, United States

  • Grace Zhang, MD

    Resident Physician
    Icahn School of Medicine at Mount Sinai
    Carmel, Indiana, United States

    • Senior Author(s)

  • Yash J. Patil, MD

    Professor and Program Director
    University of Cincinnati MedicalCenter/College of Medicine
    Cincinnati, OH, United States

Disclosure(s):
Alexander Karabachev, MD: No relevant relationships to disclose.
Adam Beucler, BS: No relevant relationships to disclose.
Christine Lee, BA, MPH: No relevant relationships to disclose.
Emma Nienaber, BS: No relevant relationships to disclose.
Grace Zhang, MD: No relevant relationships to disclose.


Introduction: Social determinants of health remain a significant factor in many health-related outcomes as well as overall life expectancy. This study aims to examine the relationship between area of deprivation index (ADI) and median household income (MHI) on length of hospital stay, discharge location and 30-day readmission for patients undergoing free flap reconstruction of the head and neck.

Methods: Retrospective review of 1,306 adult patients who underwent head and neck free flap reconstruction by a single surgeon at a tertiary medical center was performed. Multivariable logistic regression was used to assess for associations of MHI and ADI quartiles with our primary postoperative outcomes (length of stay, discharge destination, 30-day readmissions). Regression analyses were controlled for race, insurance type, tracheostomy during initial surgery, primary tumor site, and clinical disease staging.

Results: Among the 1,306 patients, 1,177 (90.3%) were white, 907 (69.4%) were male, and the median age at the time of surgery was 63 years old. Median MHI of the cohort was $61,118 (IQR, $51,110-$72,440) and median ADI was 65 (IQR, 49-81). Patients stayed a median of 7 days in the hospital (IQR, 5-10). There were 704 patients (55.0%) that were discharged home while 576 patients (45.0%) were discharged to another care facility (skilled nursing facility, long-term acute care, inpatient rehabilitation). In the first 30 days following surgery, 254 patients (19.4%) were readmitted to the hospital. Neither MHI quartile or ADI quartile was associated with discharge destination or 30-day readmissions on multivariate logistic regression; however, ADI quartile was independently associated with length of hospital stay (β = 0.59, P = 0.01).

Conclusions: Discharge destination and 30-day readmission were not significant factors affected by ADI and MHI for patients undergoing free flap reconstruction of the head and neck. However, patients living in neighborhoods with a higher area of deprivation index were shown to have a longer hospital admission.