The burden of hyponatremia and hypercalcemia on hospitalizations and mortality in lung cancer patients in the United States: An analysis of nationwide inpatient database.

Abstract

e18256 Background: In 2018, there were over 234,030 patients diagnosed with lung cancer in the US with over 154,050 deaths. While the incidence continues to fall (mostly due to reduced tobacco consumption ), the mortality continues to be high with an overall median five year survival rate of only 19%. It is important to identify factors which are associated with worse outcomes in these patients. We aim to note the trends in patients hospitalized with lung cancer who have hyponatremia and hypercalcemia. Methods: We used the Nationwide Inpatient Sample (2002-2013) to identify lung cancer hospitalizations with hyponatremia and hypercalcemia. We analyzed trends in incidence, in-hospital mortality, length of stay (LOS) and cost. We calculated adjusted odds ratios (aOR) for outcomes including in-hospital mortality. Results: A total of 1,404,228 patients were studied with lung cancer were hospitalized from 2005-2014. A number of admissions has been progressively declining from 159,568 in 2005 to 123,305 in 2014 with a relative decline of 21.8%. The overall incidence of hyponatremia in these patients was 8.62%, and it has been trending up from 6.79% to 10.48% (p < 0.001) from 2005-2014 with a relative increase of 57%. Hypercalcemia was reported in 2.59 % of patients admitted with lung cancer. The number of hospitalizations in lung cancer patients with hypercalcemia has increased from 2.19% to 3.17% (p < 0.001) with a relative increase of 49.3%. Hospitalizations for hyponatremia and hypercalcemia were more frequent in age 50-64 years, males and smokers. Lung cancer patients with hyponatremia have in-hospital mortality of 12.9 % (OR 1.43, p < 0.001). Patients who have hypercalcemia have in hospital mortality of 17.1%( OR 1.15, p < 0.001). Conclusions: This study studies trends in hospitalizations in patient with lung cancer and incidence of hyponatremia and hypercalcemia. It is noted that hyponatremia and hypercalcemia are associated with increase the risk of in hospital mortality and increase cost of care in lung cancer patients. Utilization of these findings in guiding management may lead to decreased hospitalizations, hospital stays, and improve outcomes for these patients.