Impact of cirrhosis on mortality in gastrointestinal malignancies: A retrospective study from nationwide database.

Abstract

e16324 Background: Cirrhosis is a leading cause of death in the United States, and it represents a significant cause of deterioration in the quality of life of patients worldwide. Patients with cirrhosis can be affected by malignant and non-malignant co-morbid conditions, which can impact their prognosis. Among these, gastrointestinal (GI) malignancies like colorectal, pancreatic, and hepatic represent some of the most prevalent tumors affecting the GI tract. As both cirrhosis and cancer rates rise, our study aims to explore the impact of cirrhosis on hospitalization outcomes in gastrointestinal (GI) Cancer. Methods: We used the National Inpatient sample from 2016-2020 and identified admission with a diagnosis of GI cancer using International Classification of Disease-10 codes. The cohort was further stratified into patients with a secondary diagnosis of Cirrhosis compared to those without cirrhosis. All analysis was performed using STATA V17, considering P < 0.05 statistically significant. Multivariate regression analysis was used, and confounding variables adjusted were age, gender, race, insurance, and baseline hospital characteristics. Results: A total of 1,391,165 admissions with GI malignancies were identified from 2016 to 2020. Among these, 272,729 (19.6%) had a secondary diagnosis of cirrhosis, while 1,118,435 (80.4%) did not. The cirrhotic cohort was more likely to be male (71.4%) compared to the non-cirrhotic cohort (55.5%). Cirrhosis was most commonly associated with hepatocellular carcinoma (81.7%), pancreatic cancer (8.1%), and colorectal cancer (5.7%). Patients with cirrhosis have higher mortality rates in various GI cancers. This includes esophageal cancer (17.0%) compared to those without cirrhosis (10.7%), with an adjusted odds ratio of 1.55 (95% confidence interval: 1.02-2.34, P < 0.05). Similarly, higher mortality rates were observed in gastric cancer (15.8%), colorectal cancer (12.6%), hepatocellular carcinoma (11.1%), biliary tract cancer (13.9%), and pancreatic cancer (11.5%) compared to those without cirrhosis, with adjusted odds ratios of 1.63, 2.06, 1.41, 1.78, and 1.41 respectively. Conclusions: In this study of 1.4 million gastrointestinal malignancy-related admissions from 2016 to 2020, 19.6% had a secondary diagnosis of cirrhosis. This cohort of patients had a higher mortality rate in various gastrointestinal cancers than those without cirrhosis. Cirrhosis was more commonly associated with hepatocellular carcinoma, followed by gastric cancer. These findings suggest that cirrhosis is a significant risk factor linked with higher mortality in gastrointestinal malignancy-related admissions. Further research is necessary to characterize this association better in order to improve outcomes for patients with cirrhosis and GI malignancies.