Inpatient outcome of solid tumor associated tumor lysis syndrome.

Abstract

e18185 Background: Tumor lysis syndrome (TLS) is a constellation of metabolic disturbances that can occur in virtually any malignancy, though it is more common in hematological malignancies given their high tumor burden and growth index. While TLS can occur in patients with solid tumors, the clinical behavior and outcome of solid tumor associated-TLS (STA-TLS) is not well characterized. Methods: We used the national inpatient sample to identify patients with STA-TLS (utilizing the ICD10 code E883; and ICD9 code 27788), from year 2010 through year 2016. Patients with both hematological malignancy and solid tumor, and patients without a cancer diagnosis were excluded. Results: A total of 11,733 patients were identified using the above criteria, of which 2117 (18.0%) had STA-TLS. The median age at admission was 63 years and 940 (44.4%) STA-TLS patients were females. The most common primary cancer sites were lung (26.8%), breast (4.2%), and colon (3.7%). Patients with STA-TLS were more likely to receive mechanical ventilation and less likely to receive red blood cell or platelet transfusion compared to those with hematological malignancies ( Table). STA-TLS was also associated with a significantly higher inpatient mortality rate and shorter length of stay than TLS in hematological malignancies ( P < 0.001). No statistically significant difference was found in the requirement of dialysis, transfusion of plasma, and cardiac arrest rates. Conclusions: STA-TLS is rare with an inferior outcome than TLS in hematological malignancies evident by a higher mechanical ventilation and mortality rate. Future studies should identify factors that impact management and outcome of STA-TLS. [Table: see text]