Understanding the relationship between obesity and in-hospital outcomes in gastric cancer patients : A nationwide analysis.

Abstract

e16050 Background: Gastric cancer is the fifth most common form of cancer and the third leading cause of cancer-related deaths worldwide. Obesity has been identified as a significant risk factor for gastric cancer, associated with increased incidence and heightened complications in hospitalized patients. Our analysis comprehensively evaluates obesity's impact on hospital-admitted gastric cancer patients. Methods: Using the National Inpatient Sample (NIS) 2020, we identified gastric cancer patients with regional and advanced metastatic disease, and they were stratified into patients with and without obesity. The primary outcome was mortality, and secondary outcomes included length of stay, the total cost of hospitalization, and other in-hospital adverse outcomes. Multivariate logistic regression analysis was used to calculate the outcomes after adjusting for confounding variables. Results: A total of 17560 patients were hospitalized with gastric cancer, among which 1720(9.8%) had the concurrent diagnosis of Obesity. The mean age of patients with and without Obesity was 63 (+/- 13.88) and 66 (+/- 12.93),p<0.001 respectively. The obese category had the greater percentage of male patients as compared to females (58.14% vs 44.85% respectively, p<0.001). After adjusting for confounding variables, Obesity was not considered as an independent predictor of mortality in patients with gastric cancer (OR=1.06(0.59-1.92); p=0.90). However, patients with Obesity had prolonged length of stay (+ 1.52 days(1.49-2.26); p=0.004) and total cost of hospitalization (+ $30977(12320-49633); p=0.001). Similarly, obese patients had an increased likelihood of Acute kidney injury (OR=1.47(1.09-1.96); p=0.01), ICU admission (OR=2.01(1.30-3.09); p=0.002), invasive (OR=2.14(1.29-3.54); p=0.003) Noninvasive mechanical ventilation (OR=5.36(2.17-13.14); p<0.001) and Heart failure (OR=1.68(1.09-2.57); p=0.02). No difference was noted in the risk of cardiac arrest (OR=1.26(0.28-5.68); p=0.76), and sepsis(OR=1.76(0.99-3.13); p=0.05). Conclusions: Obesity in patients with gastric cancer is not an independent predictor of mortality but is associated with increased length of stay, the total cost of hospitalization, increased risk of mechanical ventilation, and ICU admissions. Management of obesity can prove crucial in averting a wide range of potential health complications and significantly enhancing the overall quality of life in gastric cancer patients. [Table: see text]