Miller AL, Holcomb AJ, Parikh AS, et al. - This pilot study was carried out to demonstrate the feasibility of a recently developed preoperative assessment tool, the Vulnerable Elders Surgical Pathways and Outcomes Analysis (VESPA), in characterizing the baseline functional status of patients undergoing major head and neck surgery and investigating the relationship between preoperative functional status and postoperative outcomes. Retrospective chart review was used to collect data on patient demographics, ablative and reconstructive procedures, and outcomes such as total length of stay, discharge disposition, delay in discharge, or complex discharge planning (delay or change in disposition). The study's inclusion criteria were met by 58 patients. The VESPA can identify major head and neck surgical patients who have a low preoperative functional status and are at risk of delayed or complex discharge planning. Such patients may benefit from more extensive preoperative counseling and discharge planning.