NATIONAL OBSERVATIONS OF MESOTHELIOMA IN PATIENTS WITH ASBESTOS EXPOSURE

Abstract

SESSION TITLE: Occupational and Environmental Lung Disease SESSION TYPE: Original Investigation Posters PRESENTED ON: October 18-21, 2020 PURPOSE: Mesothelioma is a rare malignancy, accounting for 0.3% of all cancer diagnosis in the country. 2-10% of patients who are exposed to asbestos develop mesothelioma. Our aim is to evaluate patient and hospital characteristics among those who are admitted with a diagnosis of mesothelioma. METHODS: We conducted a retrospective analysis of the latest Nationwide Inpatient Sample database. Patients admitted with a diagnosis of mesothelioma and asbestos exposure were identified using the ICD10-CM codes. A weighted descriptive analysis was performed to generate national estimates of patients with asbestos exposure and subsequent mesothelioma. Patients were stratified by age, sex, race, and demographic and clinical data including Charlson comorbidity index. Socio demographic patient characteristics and hospital characteristics of patients were analyzed as were secondary outcomes such as length of stay (LOS) and total hospital charges. Analyses was done using the STATA statistical software. RESULTS: In 2017, a total of 23,505 had asbestos exposure out of which 2025 patients had mesothelioma, of which 91% were males. Caucasians accounted for majority of the patients admitted for mesothelioma followed by African Americans (AA) at 86% vs 7%. The mean age of patients with mesothelioma was found to be 74.37 years. The Southern hospitals (30.2%) had the maximum number of admissions followed by the Midwest (27.9%) with the Northeast (18.6%) having the least. 53% of the patients were admitted to large hospitals. After adjusting for age, gender, race, income quartile, Charlson comorbidity index, hospital location, and bed-size, presence of mesothelioma was not found to increase all cause in-hospital mortality (aOR=2.16, p= 0.214). There were no statistical differences in all cause in-hospital mortality with respect to hospital region, location, teaching status, bed size, or insurance status of patients with asbestos exposure. There were no differences in LOS for patients with mesothelioma and those without. Total hospital charges varied significantly based on hospital region with Southern and Northwest regions having varying charges when compared to the Northeast. (aOR -10125, p=0.024 and aOR= 15088, p=0.007). CONCLUSIONS: Our analyses showed that 8.6% of patients with asbestos exposure also had a diagnosis of mesothelioma, similar to known trends. Majority of patients were Caucasian males. Regional variation exists in the incidence of mesothelioma in patients with asbestosis. CLINICAL IMPLICATIONS: The burden of occupational diseases on health care system has been rather undermined. Further trials are required to identify high-risk populations, so that targeted interventions such as early screening can be undertaken. DISCLOSURES: No relevant relationships by Ayesha Azmeen, source=Web Response No relevant relationships by Naga Vaishnavi Gadela, source=Web Response Speaker/Speaker's Bureau relationship with Astra Zeneca, GSK Please note: $1001 - $5000 Added 06/11/2020 by Daniel Gerardi, source=Web Response, value=Honoraria No relevant relationships by Anand Muthu Krishnan, source=Web Response