Abstract PO-003: Predictors for 30-day readmission in patients with pancreatic cancer who had DNR code status

Abstract

Abstract Background: Pancreatic cancer is a lethal malignancy, and most patients present with advanced disease. There is little known about the 30-day readmission rate in patients with Do-not resuscitate (DNR) code status in pancreatic cancer. The study aims to look for predictors for 30-day readmission in pancreatic cancer patients with DNR code status. Methods: This is a retrospective study of a nationally representative cohort of hospitalized admissions admitted from January 1, 2016, to December 31, 2018; 240,107 index pancreatic cancer hospitalizations were recorded. The database was obtained from the Agency for Healthcare Research and Quality’s (AHRQ) Healthcare Cost and Utilization Project (HCUP) national readmission (NRD) dataset files between 2016 – 2018. We examined predictors of death and 30-day readmission among patients with pancreatic cancer who had DNR code status. We evaluated readmission in pancreatic cancer with DNR code status in multivariable Cox hazard regression models. Results: There were 240,107 index hospitalizations with pancreatic cancer (PAC) for the years 2016-2018. There were 51,451 (21.4%) PAC patients who had DNR code status during the index hospitalization. Patients with DNR status had a mean age of 68. The PAC patients with DNR status had significantly higher numbers of inpatient mortality (22% (DNR status) vs 3% (full code) (OR 4.24 (95% CI 3.9-4.6; P <0.001), higher rate of cardiac arrhythmia (26% vs. 19%; p<0.001). The adjusted odd’s ratio (Table 1.) to look for significant readmission predictors for DNR status in PAC included chronic heart failure (OR 1.24, p <0.001), renal failure (OR 1.27, p<.001), and liver disease (OR 2.13, p <0.001). However, patients with diabetes and obesity were found to have a negative association with readmission. Most patients were treated in urban teaching hospitals, and Medicare was the primary payor in 70.4%. Conclusion: In this large nationwide study, we observed higher inpatient mortality and readmission rates in pancreatic cancer who have DNR code status utilizing hospital resources and healthcare costs. This suggests that patients with advanced pancreas cancer who adopt DNR status be offered early hospice care to avoid inpatient mortality. There is a need to look for data based on racial and ethnic differences. Citation Format: Jasmeet Kaur, Tanveer Mir, Paramveer Singh, Judie Goodman. Predictors for 30-day readmission in patients with pancreatic cancer who had DNR code status [abstract]. In: Proceedings of the AACR Virtual Special Conference on Pancreatic Cancer; 2021 Sep 29-30. Philadelphia (PA): AACR; Cancer Res 2021;81(22 Suppl):Abstract nr PO-003.