Comorbidities in patients with sarcoma: Insights from the National In-Patient Database from 2006 to 2014.

Abstract

e23534 Background: Sarcoma represents a rare solid malignancy in adults. Given the likelihood of metastatic disease, the prognosis is usually poor. Comorbidities are independent determinants of prognosis, and cardiovascular and respiratory diseases are the most common. We aimed to study the prevalence, trends, and outcomes of CVD and pulmonary circulation disorders in patients admitted with sarcoma over eight years. Methods: We present a retrospective analysis of hospital admissions for soft tissue malignancies between 2006 and 2014 from the NIS database using its respective ICD-9-CM code. We obtained the prevalence of cardiovascular diseases (HF, CAD, HTN) and pulmonary circulatory disorders (PE, PHTN). We assessed yearly trends with the Cochran-Armitage trend test. Using multivariate binomial logistic regression (adjusting for sex, race, age, and Elixhauser comorbidities) we calculated adjusted odds ratios (aOR) to identify the association of these comorbidities with in-hospital mortality. Results: Between 2006-2014 there were 352320 admissions with a primary diagnosis of soft tissue malignancies. Of them, 55.8% were males, 60% were white, and 57.5% were 50 years old and older. In 39% of the population, CVD was present: HTN 35.5%, CAD 8.5%, HF 4.5%. The rate of pulmonary circulatory disorders was 2.5%: PE 1.7%, and pulmonary hypertension 0.9%. In-hospital mortality accounted for 3.7% of admissions. The CVD yearly prevalence increased from 34.6% in 2006 to 41.7% in 2014 (p < 0.001). Pulmonary circulatory disorders rose from 1.7% in 2006 to 3.3% in 2014 (p < 0.001). Pulmonary circulatory diseases were associated with high in-hospital mortality aOR 3.02 (CI 95% 2.44-3.73, p = 0.00). Cardiovascular disease was not statistically significantly associated with an increased rate of in-hospital mortality aOR 1.04 (CI 95% 0.93-1.15, p = 0.53). Conclusions: In sarcoma patients, it is essential to quantify their comorbidities as these often influence their chosen therapy. Cardiovascular disease affected one-third of the patients. However, despite the low prevalence of pulmonary circulatory disorders, they were associated with high in-hospital mortality. Further studies are needed to understand the causality and underlying physiopathology.