Venous Thromboembolism in Patients Hospitalized With Localized, Regional, and Metastatic Head and Neck Cancer

Background Venous thromboembolism (VTE) is a known complication in cancer patients, but data in head and neck cancer (HNC)–particularly distinguishing localized, regional, and metastatic disease–are limited. Methods Using the 2016–2020 National Inpatient Sample, we examined adults ≥ 18 years with HNC, excluding patients with another primary malignancy. Metastatic status was categorized as localized, regional, and metastatic. Outcomes included odds of VTE, pulmonary embolism (PE), deep vein thrombosis (DVT), inhospital mortality, and prolonged length of stay (LOS ≥ 7 days). Multivariable logistic regression identified factors associated with these outcomes. Results Among 62 032 unweighted (310 160 weighted) admissions, 75.0% had localized HNC, 12.7% had regional HNC, and 12.3% had metastatic HNC; 2.6% had VTE (2.4% localized HNC, 2.3% regional HNC, and 4.1% metastatic HNC). Compared with localized HNC, regional HNC was not associated with increased odds of VTE, PE, or DVT, whereas metastatic HNC was associated with higher adjusted odds of VTE (aOR 1.52; 95% CI: 1.30–1.78), PE (aOR 1.61; 95% CI: 1.32–1.98), and DVT (aOR 1.47; 95% CI: 1.18–1.83). VTE was associated with increased inhospital mortality (aOR 1.98; 95% CI: 1.64–2.40) and prolonged LOS (aOR 2.14; 95% CI: 1.92–2.39). Conclusion In hospitalized patients, distant, but not regional, metastatic HNC is associated with higher odds of VTE, and VTE is associated with adverse in‐hospital outcomes including increased mortality and prolonged LOS.