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Scientific Oral Presentation

Head and Neck Surgery

Persistent Poverty and Outcomes in Head and Neck Free Flap Reconstruction

Sunday, October 18, 2026
3:06 PM - 3:12 PM PT
Location: West Exhibit Hall A, Learning Zone 3

    Presenting Author(s)

  • Kelly M. Atherton, MD, MSCR

    Resident Physician
    University of Alabama Medical Center
    Birmingham, AL, United States

    • Senior Author(s)

  • Anne C. Kane, MD

    Associate Professor
    University of Alabama at Birmingham
    Birmingham, Alabama, United States

    • Co-Author(s)

  • TD

    Theodore Dowd, n/a

    Medical Student
    UAB Heersink School of Medicine
    Birmingham, Alabama, United States

  • LM

    Luke S. Mondia, MBA

    Medical Student
    University of Alabama Heersink school of Medicine
    Birmingham, AL, United States

  • SB

    Sydney Booth, Other

    Medical Student
    University of Alabama Heersink school of Medicine
    Birmingham, Alabama, United States

  • NK

    Nicolaus D. Knight, n/a

    Clinical Data Specialist
    University of Alabama Birmingham Otolaryngology Chair Office
    Birmingham, Alabama, United States

Disclosure(s):
Kelly M. Atherton, MD, MSCR:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: Residing in Areas of Persistent poverty (AoPP) has been found to be associated with high rates of systemic healthcare barriers and significantly impacts cancer mortality rates. Previous research has identified worse survival outcomes in oral cavity and pharyngeal cancer for those living in AoPP areas, however there is otherwise limited research on how residing in an AoPP influences head and neck cancer and reconstructive surgery outcomes. We seek to evaluate AoPP as an independent predictor of adverse outcomes after head and neck free flap reconstruction.

Methods: This study is a retrospective chart review of adult patients who underwent head and neck (H&N) free flap reconstruction at a single tertiary academic center between the years of 2016-2025. Data collected included patient demographics, AoPP census tract, cancer and flap characteristics and surgical and post-operative outcomes. Preliminary analysis was performed on currently collected data.

Results: Preliminary analysis of 621 patients revealed a significant relationship between residing in AoPP and younger age at time of surgery (p=0.039) and Black/African American race (p < 0.001). Those residing in AoPP were less likely to drink alcohol (p=0.016). Preliminary analysis did not identify a significant relationship between residence in AoPP and cancer T stage, medical comorbidities, or post-operative outcomes of 30-day readmission, wound or flap complications, post-operative death, or discharge disposition. Further analysis is anticipated with completion of data collection.

Conclusions: Further research is warranted to examine the relationship between AoPP and H&N cancer oncologic and reconstruction outcomes. This study will add to the literature in further elucidating the impacts of social determinants of health, in particular neighborhood and built environment on outcomes in the patient population to inform future intervention research.