PCN44 NATIONAL TRENDS IN ADMISSION AND IN-HOSPITAL MORTALITY OF PATIENTS WITH LUNG CANCER IN THE UNITED STATES, 2012-2016

Abstract

While the incidence of lung cancer has decreased slightly since 2005, it continues to be the leading cause of cancer mortality in both men and women. We investigated hospitalization and in-hospital mortality trends in the US over the most recent period of data availability. Using 2012-2016 data from the National Inpatient Sample, admissions with a diagnosis of lung and bronchus cancer were identified. Descriptive measures, including demographics, length of stay (LOS), discharge disposition, and total cost (adjusted for inflation using medical care component), stratified by year. Discharge-level weights were applied to represent national estimates and domain analysis was used for subpopulation estimates. An annual percentage change was also calculated to characterize the trend in hospitalization rates over time. In 2016, there were 558,725 admissions of patients with a diagnosis of lung cancer. Mean (95% confidence interval) age was 69.7 (69.6-69.9) years, 49.6% (49.2%-50.0%) female, 69.1% (68.5%-69.7%) had Medicare as the primary payer, and 76.7% (75.6%-77.8%) were White. Mean age increased each year from 69.3 (69.2-69.5) years in 2012 (p=0.001). Hospitalization rates declined from 182 per 100,000 people in 2012 to 173 per 100 000 people in 2016, with an average annual decline of 1.1% (0.1%-2.2%; p=0.042). Mean LOS was 5.8 (5.8-5.9) in 2012 and 5.8 (5.7-5.8) from 2013-2016 (p=0.320). In-hospital mortality was highest in 2012 and 2014 (7.6% [7.4%-7.8%]) of admissions, and was lowest in 2016 (7.3% [7.1%-7.5%]) (p=0.056). Mean cost of admission was $15,088 ($14,803-$15,372) in 2012 and $14,735 ($14,442-$15,028) in 2016 (p=0.492). From 2012-2016 the admission rate for lung cancer declined significantly. This is consistent with the observed decline in lung cancer incidence over the same period. In-hospital mortality declined by a statistically non-significant amount, although the magnitude was consistent with the observed reduction in overall lung cancer mortality over the same period.