Frequency of loco-regional complications and their IMPACT on hospitalization outcomes in patients with cholangiocarcinoma.

Abstract

e16135 Background: Cholangiocarcinomas, based on their anatomic location are prone to a myriad of local and regional complications. This study aims to explore if the outlook of patients differs based on what type of loco-regional complications they are admitted with. Methods: The National Inpatient Sample (NIS) was queried to identify adult patients with underlying cholangiocarcinoma between 2016-2018. Relative frequency and diagnosis of locoregional complications as principal diagnosis in these patients were identified and top 5 loco-regional complications were studied and compared for all-cause mortality, mean length of stay (LOS), mean total hospital charges (THC). Statistics were performed using t-test, univariate and multinomial logistic regression. Results: There were 26,410 hospitalizations in patients with cholangiocarcinoma. Upper gastrointestinal bleed (UGIB) represented the most frequent loco-regional complication (9.2%), followed by acute liver failure and cancer pain admission (6.7% each). Mortality rate of all admissions was 5.84%; all complications except failure to thrive were associated with significantly increased odds of mortality, the highest in acute liver failure (AOR- 3.72). Except admissions for cancer associated pain, all complications were associated with statistically significant increased LOS, highest in UGIB (Adjusted mean difference of 5 days). Similarly, admission with UGIB was associated with the highest THC while cancer pain admission had a much lower cost. Conclusions: Among the loco-regional complications of cholangiocarcinoma that were studied, UGIB was the most frequent, associated with longest hospital LOS (5 extra days) and highest THC. Admission with acute hepatic failure was associated with the highest odds of mortality while cancer associated pain and failure to thrive were associated with the shortest length of stay and lowest mean charges. Further efforts are needed to improve outpatient pain management to prevent these admissions and identify ways to improve outcomes in patients with UGIB. [Table: see text]