Prevalence and outcomes of acute kidney injury among hospitalized patients with gastric cancer: Insights from a National Inpatient Sample study (2018-2020).

Abstract

e16124 Background: Acute kidney injury (AKI) occurs in 50-60% of the patients admitted to the hospitals, and up to almost 20% of those patients have underlying cancer. AKI has been associated with high mortality and adverse outcomes in cancer patients. This relationship between cancer and kidney health, known as "the kidney-cancer connection has attracted considerable interest in research circles. In this study, we aimed to evaluate the outcome of AKI in hospitalized patients with gastric cancer. Methods: A retrospective analysis was conducted using the National Inpatient Sample database from 2018 to 2020 and the ICD- 10 codes to identify the patients > 18 years old with the principal diagnosis of Gastric Cancer. We evaluated the effect of acute kidney injury (AKI) on mortality, morbidity outcomes, and resource usage in patients with gastric cancer. Categorical variables underwent comparison using the chi-square test, while continuous variables were compared using the t-test. Multivariate analysis was conducted to derive the odds ratio, and all weighted analyses were carried out using STATA. Results: We identified a total of 123,935 patients with a primary diagnosis of gastric cancer who were hospitalized between 2018 and 2020 in the United States. Out of them, 20% (24,787) of the patients had developed acute kidney injury during the hospital admission. The mean age of the patients was 69 years. Of these patients, 67% were male, and the remaining 33% were female. The mortality for gastric cancer patients with AKI was 18.3%, while it was 4.7% for patients without AKI. After adjusting for confounders, AKI had higher odds of mortality (Adjusted odds ratio [aOR] for mortality 4.41, 95% confidence interval [CI]: 3.96-4.91, P < 0.001). AKI was also associated with higher resource utilization, including a higher length of stay (LOS) (mean LOS increased by 9.5 days vs 6.5 days in patients without AKI) and higher hospital charges (by $127,814). Conclusions: Our study concludes that the patients with gastric cancer who developed Acute Kidney Injury during the hospital stay had worse outcomes. Identifying AKI early on can help with timely intervention, which can reduce adverse outcomes. Thus it is extremely important for nephrologists and oncologists to closely monitor patients' renal function throughout their treatment.[Table: see text]