Abstract
ObjectivesLittle is known about the current status and the changing trends of hospitalization and palliative care consultation of patients with gastric cancer in the United States. The aim of this study was to evaluate the changing trend in the number of hospitalization, palliative care consultation, and palliative procedures in the US during a recent 10-year period using a nationwide database.MethodsThis was a retrospective study that analyzed the National Inpatient Sample (NIS) database of 2009–2018. Patients aged more than 18 years who were diagnosed with a gastric cancer using International Classification of Diseases (ICD)-9 and 10 codes were included. Palliative care consultation included palliative care (ICD-9, V66.7; ICD-10, Z51.5) and advanced care planning (ICD-9, V69.89; ICD-10, Z71.89). Palliative procedures included percutaneous or endoscopic bypass, gastrostomy or enterostomy, dilation, drainage, nutrition, and irrigation for palliative purpose.Results and discussionA total of 86,430 patients were selected and analyzed in this study. Using a compound annual growth rate (CAGR) approach, the annual number of hospitalizations of gastric cancer patients was found to be decreased during 2009–2018 (CAGR: -0.8%, P = 0.0084), while utilization rates of palliative care and palliative procedures increased (CAGR: 9.3 and 1.6%, respectively; P < 0.0001). Multivariable regression analysis revealed that palliative care consultation was associated with reduced total hospital charges (−$34,188, P < 0.0001).ConclusionUtilization of palliative care consultation to patients with gastric cancer may reduce use of medical resources and hospital costs.
Highlights
Gastric cancer is the 3rd leading cancer-related cause of death with more than 720,000 deaths per year worldwide
Almost two thirds of the cohort belonged to APR-DRDG 3 and 4 categories (46.3 and 17.8%, respectively)
It is expected that patients near end of life (EOL) due to advanced illness usually receive more palliative care consultation with less interventional or life-sustaining procedures such as ventilation, cardiopulmonary resuscitation, blood transfusion, and dialysis [18]
Summary
Gastric cancer is the 3rd leading cancer-related cause of death with more than 720,000 deaths per year worldwide. Joo et al BMC Health Services Research (2022) 22:20 pylori, the strongest etiologic factor of stomach cancer, the global incidence of gastric cancer is steadily declining [2]. With dramatic improvement of endoscopic techniques for visualization and resection of early gastric cancer (EGC), early detection and curative endoscopic resection of EGC have made a significant contribution to the decline of cancer-related mortality [3]. If gastric cancer is diagnosed at a later stage with distant metastasis, chance for cure declines dramatically and overall prognosis remains poor. A previous study has shown that if gastric cancer is diagnosed at stage III or IV, overall 5-year survival rate is only 35% regardless of surgical resection of tumor [4]
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