Outcomes in patients with anemia hospitalized for endometrial cancer resection: A nationwide analysis.

Abstract

e17585 Background: Endometrial cancer is the most common gynecological malignancy, and It is notably associated with the development of anemia. In light of this, we conducted a retrospective analysis to determine the impact of anemia on patients hospitalized for endometrial cancer resection and other complications during hospitalization. Methods: We conducted a study using the National Inpatient Sample (NIS) data from 2019 and 2020 to identify patients who were admitted with a primary diagnosis of endometrial cancer resection and had a concurrent secondary diagnosis of anemia. Primary outcomes included mortality, and secondary outcomes were the length of stay, total hospitalization charges, and other adverse hospital outcomes. Multivariate logistic regression analysis was used to adjust for confounding variables. Results: A total of 375,109 patients were hospitalized for resection of Endometrial cancer, among whom 55,345 had concurrent anemia. After adjusting for confounding factors, no difference in mortality between the two groups was observed(OR=1.37, 0.91-2.07; p=0.127). However, patients with anemia had a longer length of stay (4.11 days without and 6.05 days with anemia, p<0.001) and a higher total cost of hospitalization ($ 81,112 without and $ 108,436 with anemia, p<0.001). Patients with anemia were at a higher risk of developing sepsis (OR=3.15, 2.60-3.82, p<0.001), acute respiratory failure (OR= 2.64, 2.19-3.19; p<0.001), ICU admission (OR= 2.30, 1.95-2.72; p<0.001), acute coronary syndrome (OR= 2.17, 1.06-4.43; p=0.032), acute kidney injury (OR= 2.78, 2.50-3.09; p<0.001), constipation (OR =1.51, 1.33-1.71; p<0.001), diarrhea (OR= 2.11, 1.61-2.76; p<0.001), pneumonia (OR =2.20, 1.70-2.84; p<0.001), red blood cell transfusion (OR= 9.45, 8.39-10.64; p<0.001), platelet transfusions (OR= 4.43, 3.19-6.16; p<0.001), venous thromboembolism (OR= 2.50, 2.07-3.03; p<0.001), enteral feeding (OR= 6.96, 1.59-30.43; p=0.01), parenteral feeding (OR= 2.91, 2.19-3.85; p<0.001), urinary tract infection (OR =2.08, 1.77-2.43; p<0.001), and the involvement of palliative care (OR= 1.59, 1.18-2.13; p<0.001). There was no difference in having chemotherapy in both groups (OR 0.79, 95% CI 0.29-2.12, p=0.652). Conclusions: Anemia is associated with increased healthcare resource utilization and adverse in-hospital outcomes in patients undergoing resection of Endometrial cancer. Anemia might not be the only predictor of mortality, but identifying and treating it before any interventions can decrease the risk of adverse outcomes and improve quality of life. [Table: see text]