Impact of economic inequality on Kaposi sarcoma of the lung: A retrospective cohort.

Abstract

e18920 Background: Kaposi Sarcoma of the lung is a rare entity; it is unclear if a below-average household income has an impact on outcomes. Methods: This is a retrospective cohort study of patients with Kaposi Sarcoma of the lung that were admitted to acute care from 2016 to 2020. Data is derived from the National Inpatient Sample (NIS). We compared outcomes in 2 cohorts: those with household income < $50,000 versus those with > $50,000. The primary endpoint was differences in all-cause in-patient mortality. Secondary endpoints included differences in length of stay (LoS) and admission cost. Results: A total of 460 patients met inclusion criteria; 40% had income < $50K, and 60% > $50K (p < 0.001). There was a trend to male predominance (100% of < $50K, 95% > $50K; p 0.147) with a mean age of 39 (35 for < 50K, 41 for > 50K; p 0.015). Black patients were the most afflicted group (46%; 71% of < $50K, 29% > $50K; p < 0.001), followed by White patients (33%, 20% of < $50K, 43% of > $50K; p < 0.001). Additionally, patients with household income < $50K (40%; p < 0.001) and hospitals located in the South (43%, 48% of < $50K, 40% of > %50K; p < 0.001) and West (32%, 11% of < $50K, 46% of > 50K; p < 0.001) represented the largest group. Majority of patients were under Medicaid insurance coverage, however there was no relationship between Medicaid coverage and mortality (p = 0.709, CI 0.16-3.42). There was no difference in distribution based on primary payer, hospital bed size, hospital teaching status, and hospital ownership (p > 0.05). No differences in mortality were noted among groups (p 0.845). No differences in LoS were seen (p 0.560), but younger patients were more likely to have shorter LoS (p 0.033). Ultimately, no differences in hospitalization costs were noted (p 0.426). Furthermore, from the 460 patients with Kaposi lung sarcoma, 5 were post-transplant patients, and 130 were patients with HIV; in this sub-group of analysis, were no differences between ages. The mean age in patients with lung transplants was 39.5, and the HIV group was 40 years. The black population was the most affected, with an income below $50 000. Conclusions: Income did not impact mortality in patients admitted for Kaposi sarcoma of the lung. Black patients and patients with income < $50,000 represented the largest group. Nevertheless, more research is needed for better stratification and to elucidate many factors that play a role in the mortality of patients with Kaposi sarcoma of the lung.