2821 Trends and In-Hospital Outcomes in Gastrointestinal Malignancies: A National Perspective

Abstract

INTRODUCTION: There is limited evidence available regarding the trends of hospitalization and in-hospital outcomes amongst various gastrointestinal malignancies. Our study measured the trends of hospitalization and the difference related to in-hospital outcomes, such as inpatient length of stay (LOS), cost and mortality in patients with various gastrointestinal malignancies. METHODS: The National Inpatient Sample (NIS) dataset was queried from 2009 to 2014 to identify all patients with a multilevel diagnosis of gastrointestinal neoplasms including cancer of the esophagus, cancer of the stomach, cancer of the colon, cancer of rectum/anus, cancer of the liver and intrahepatic bile duct and cancer of the pancreas. Categorical and continuous variables were tested using Chi-square test and Student t-test respectively. RESULTS: We identified a total of 1,995,281 patients with a diagnosis of neoplasm from 2009 to 2014. Among them, 15,276 (0.8%) had cancer of the esophagus, 28,018 (1.4%) had cancer of the stomach, 114,917 (5.8%) had cancer of the colon, 49,690 (2.5%) had cancer of the rectum and anus, 26,565 (1.3%) had cancer of liver and intrahepatic bile duct, 44,749 (2.2%) had cancer of the pancreas. We found that colon cancer had the highest inpatient mortality rate of 5.8% while esophageal cancer had the lowest at 0.8%. The mean LOS for cancer of the stomach was the longest (≈9.49 days) while the cost of care was highest for esophageal cancers (26752.84$). More importantly, the trend of hospitalization among all the major subtypes of gastrointestinal malignancies was significantly unchanged over the period of 5 years. CONCLUSION: Gastrointestinal malignancies in the United States represent a significant burden of disease. Our study provides further evidence that there is a significant burden of cost, hospitalization, as well as mortality in this cohort of patients. Given the alarming increase in the incidence of gastrointestinal malignancies and related deaths, such data may have profound implications regarding future demographics to focus research, screening or preventative measures accordingly.