Outcomes of colorectal cancer hospitalization with and without coexisting nutritional anemia: A National Inpatient Sample (NIS) 2016 to 2019 database study.

person Sagar Pandey One Brooklyn Health System/Interfaith Medical Center, Brooklyn, NY info_outline Sagar Pandey, Madhav Changela, Kapilkumar Manvar, Dhruvanshu Patel, Sanket Basida, Yash Shah, Tejas Karawadia, Madhumati R. Kalavar

Authors person Sagar Pandey One Brooklyn Health System/Interfaith Medical Center, Brooklyn, NY info_outline Sagar Pandey, Madhav Changela, Kapilkumar Manvar, Dhruvanshu Patel, Sanket Basida, Yash Shah, Tejas Karawadia, Madhumati R. Kalavar Organizations One Brooklyn Health System/Interfaith Medical Center, Brooklyn, NY, One Brooklyn Health System/Brookdale University Hospital and Medical Center, Brooklyn, NY, St. Luke's University Health Network, Bethlehem, PA, University of Missouri, Columbia, MO, Trinity Health Oakland, Pontiac, MI, Cancer Specialists of North Florida, Jacksonville, FL, NYP Brooklyn Methodist Hospital, Brooklyn, NY Abstract Disclosures Research Funding No funding sources reported Background: Colorectal carcinoma (CRC) is third most commonly diagnosed cancer in males and second in females. Implications of CRC with coexisting anemia and its outcomes of hospitalization have not been studied. We aim to evaluate the outcomes of CRC hospitalization with and without coexisting nutritional anemia. Methods: A total of 504,515 patients (male: 52.61%, female: 47.39%), aged ≥18 years, admitted from 2016 to 2019 with principal admission diagnosis of CRC were identified using International Classification of Disease 10 (ICD-10) coding for NIS database. Patients were stratified into those with and without nutritional anemia (16.19% vs 83.81%) which included iron, B12, folate deficiency and other nutritional anemia per ICD-10 coding. Mortality was the primary outcome of the study whereas length of stay (LOS), total treatment cost, acute kidney injury (AKI), pulmonary embolism (PE), deep vein thrombosis (DVT), colonoscopy, abdominal surgery and lower gastrointestinal (GI) bleeding were secondary outcomes. Multivariate regression model was used to estimate the outcomes of CRC hospitalization with and without coexisting nutritional anemia after adjusting for confounders like age, sex, race, insurance provider, co-morbidities, median income, hospital region, location, etc. Results: Mean age of patients admitted with CRC with and without anemia was 69.06 and 65.77 years respectively. Among two groups, mortality was significantly lower among patients with nutritional anemia (2.05 % vs 2.64 %). Lower GI bleeding (12.24% vs 4.77%) and colonoscopy during inpatient stay (43.97% vs 23.05%) were significantly higher among CRC cohort with nutritional anemia. Similarly, LOS, cost of inpatient hospitalization, AKI, PE and DVT were also significantly higher among anemia cohort. However, the need for abdominal surgery was significantly higher among CRC patients without nutritional anemia. Table 1 summarizes the results of multivariate regression analysis. Conclusions: Nutritional anemia in CRC patients is associated with longer length of stay, increased cost, higher risk of developing venous thrombosis along with lower GI bleed and colonoscopy. Therefore, it should be corrected to optimize outcomes among CRC patients. Multivariate regression analysis on outcomes of CRC hospitalization with and without nutritional anemia. Outcomes Anemia No Anemia Adjusted Odds Ratio Unadjusted Odds Ratio P Value 1. Mortality (%) 2.05 2.64 0.62 0.77 < 0.001 2. LOS (days) 3.73 2.56 1.17 * 1.58 * < 0.001 3. Total Charge ($) 46895 39546 7313 * 9500 * < 0.001 4. AKI (%) 15.23 10.36 1.24 1.56 < 0.001 5. PE (%) 2.06 0.98 1.91 2.13 < 0.001 6. DVT (%) 3.04 1.62 1.59 1.90 < 0.001 7. Colonoscopy (%) 43.97 23.05 2.49 2.61 < 0.001 8. Abdominal Surgery (%) 51.91 56.85 0.87 0.81 < 0.001 9. Lower GI bleed (%) 12.24 4.77 2.39 2.78 < 0.001 * adjusted/unadjusted coefficient.