P2113 - Pancreatic Cancer: An Overview of National Trends and Adverse Outcomes in the United States From 2008 to 2017

Tuesday, October 26, 2021

10:30 AM – 4:00 PM PT

Location: Shoreline Exhibit Hall

Has Audio

Presenting Author(s)

Dushyant S. Dahiya, MD

Central Michigan University College of Medicine
Saginaw, MI, United States

Asim Kichloo, MD¹, Dhanshree Solanki, MHA², Dushyant S. Dahiya, MD¹, Jagmeet Singh, MD³, Khwaja F. Haq, MD⁴, Manasee Vyas, MBBS⁵, Shantanu Solanki, MD, MPH⁶, Mohammad Al-Haddad, MD⁷
¹Central Michigan University College of Medicine, Saginaw, MI; ²Rutgers University, New Brunswick, NJ; ³Guthrie/Robert Packer Hospital, Sayre, PA; ⁴Stony Brook University Hospital, Stony Brook, NY; ⁵Mahatma Gandhi Mission Institute of Health Sciences, Mumbai, Maharashtra, India; ⁶Geisinger Commonwealth School of Medicine, Sayre, PA; ⁷Indiana University, Indianapolis, IN

Introduction: Pancreatic cancer is the third leading cause of cancer death in the US. However, there is paucity of data on pancreatic cancer hospitalizations.

Methods: We analyzed the Nationwide Inpatient Sample (NIS) from 2008–2017 to identify all adult hospitalizations (≥ 18 years) of pancreatic cancer. We calculated the frequency of hospitalization for age, gender, race, hospital characteristics, median household income, insurance status, type of admission, and disposition status. We also assessed length of stay (LOS), discharge patterns and indications for admissions (emergent vs elective). The analysis was performed via SAS 9.3 using Cochrane-Armitage trend test for categorical variables and Wilcoxon Rank Sum Test for continuous variables.

Results: We noted significant variance but an overall increase in the total number of pancreatic cancer hospitalizations from 37,123 in 2008 to 37,635 in 2017 (p < 0.0001) (Table 1). Patients aged 65–79 years had the highest rate of hospitalizations with a rising trend from 41.6% in 2008 to 45.9% in 2017 (p < 0.0001). In 2008, a female predominance was noted (51.9% vs 48.1%, p < 0.0001); however, there was a shift to male predominance in 2012 (50.9% vs 49.1%, p < 0.0001) and thereafter (Table 1). Whites made up a majority of the study population and the South hospital region saw the most hospitalizations (Table 1). Emergent or urgent hospitalizations decreased from 54.1% in 2008 to 50.7% in 2017 (p < 0.0001) while elective hospitalizations increased from 45.9% in 2008 to 49.3% in 2017 (p < 0.0001). The mean LOS decreased from 8.4 days in 2008 to 7 days in 2017 (p < 0.0001). Furthermore, there was an increase in home discharges from 72% in 2008 to 76.2% in 2017 (p < 0.0001) while inpatient mortality decreased from 10.1% in 2008 to 7.6% in 2017 (p < 0.0001) for these hospitalizations.

Discussion: In the US, there was significant variance but an overall increase in the total number of pancreatic cancer hospitalizations between 2008–2017 with a rising prevalence noted in men. This may in part be secondary to increased exposure to modifiable risk factors such as smoking and alcohol use. During 2008–2017, there was a decrease in the mean LOS and inpatient mortality for pancreatic cancer hospitalizations. This may reflect early detection and improvements in therapeutic management; however, it may also, in part, be due to increased home discharges per patient preference.

VARIABLE					YEAR						p-value
	2008	2009	2010	2011	2012	2013	2014	2015	2016	2017
Number of Hospitalizations (n)	37,123	34,839	38,362	38,495	35,625	34,925	35,465	35,925	37,435	37,635	< 0.0001
Age in years (%)
< 18	0.1	0.2	0.2	0.1	0.1	0.1	0.1	0.1	0.2	0.1	0.19
18-34	0.7	0.5	0.5	0.5	0.5	0.5	0.8	0.6	0.5	0.5	0.34
35-49	7.0	6.7	7.2	6.1	6.3	5.7	5.7	5.3	5.3	5.4	< 0.0001
50-64	29.9	30.4	32.2	30.9	32.5	31.3	32.3	32.4	31.7	30.6	< 0.0001
65-79	41.6	41.2	40.1	42.2	40.6	42.5	42.4	42.8	44.4	45.9	< 0.0001
>=80	20.7	20.9	19.8	20.2	20.0	19.8	18.9	18.9	18.0	17.5	< 0.0001
Gender (%)
Male	48.1	50.0	49.6	48.0	50.9	50.7	50.4	50.4	51.4	50.9	< 0.0001
Female	51.9	49.9	50.4	51.9	49.1	49.3	49.5	49.5	48.4	49.1	< 0.0001
Race (%)
White	62.4	61.7	66.0	67.7	68.4	68.3	68.4	67.6	67.7	67.5	< 0.0001
Black	8.8	10.3	13.2	11.6	12.6	12.5	12.3	13.6	13.3	13.6	< 0.0001
Hispanic	6.1	7.1	6.6	7.7	7.1	7.8	8.2	8.1	8.0	8.1	< 0.0001
Asian or Pacific Islander	2.4	3.2	2.2	2.5	2.7	3.3	3.0	2.8	3.1	3.0	0.02
Native American	0.3	0.5	0.4	0.3	0.5	0.4	0.3	0.3	0.5	0.3	0.05
Others	2.6	2.6	2.0	2.8	3.2	2.8	2.8	2.7	3.0	3.9	< 0.0001
Missing	17.5	14.7	9.6	7.5	5.6	4.8	5.2	4.9	4.6	3.6
Hospital Region (%)
Northeast	23.1	20.1	22.5	20.5	21.6	22.7	22.4	20.5	21.8	22.0	0.32
Midwest	20.8	24.1	23.5	22.9	22.6	21.4	21.7	21.6	21.4	22.1	< 0.0001
South	34.2	35.0	36.2	38.8	37.6	37.7	37.5	39.5	38.3	37.2	< 0.0001
West	22.0	20.9	17.8	17.8	18.2	18.2	18.4	18.4	18.6	18.8	< 0.0001
Hospital Location (%)
Rural	7.2	7.4	7.3	5.5	6.0	5.6	4.3	4.1	4.1	4.2	< 0.0001
Urban nonteaching	33.6	32.3	29.9	29.9	28.2	28.0	18.1	19.2	17.6	15.8	< 0.0001
Urban teaching	59.1	58.6	62.0	63.4	65.8	66.4	77.6	76.8	78.2	80.0	< 0.0001
Median Household Income (%)
Quartile 1	23.1	24.4	26.1	26.8	26.7	25.1	24.9	27.1	25.9	25.6	< 0.0001
Quartile 2	26.4	25.1	24.2	23.0	23.1	24.8	26.9	24.3	24.8	25.5	0.4
Quartile 3	23.1	24.2	23.1	25.8	24.2	23.9	22.8	23.7	24.0	23.7	0.09
Quartile 4	24.9	24.1	24.5	22.5	24.0	23.7	23.3	23.1	23.8	23.6	< 0.0001
Insurance Status (%)
Medicare/Medicaid	63.0	62.1	63.6	65.0	65.1	65.6	66.5	66.3	66.8	66.6	< 0.0001
Private insurance	31.0	31.7	29.5	28.4	27.7	27.6	27.8	28.0	27.8	27.9	< 0.0001
Uninsured/self-pay	5.8	6.1	6.7	6.4	6.9	6.6	5.5	5.6	5.4	5.2	< 0.0001
Hospital Bed Size (%)
Small	7.3	10.7	10.0	8.6	10.2	9.9	13.0	11.5	12.7	12.2	< 0.0001
Medium	19.5	19.6	17.2	19.1	22.7	22.3	25.1	25.2	23.8	24.4	< 0.0001
Large	73.2	67.9	72.1	71.1	67.0	67.8	61.9	63.3	63.5	63.4	< 0.0001
Type of Admission (%)
Emergent or Urgent	54.1	53.1	57.4	57.8	55.7	54.7	53.5	52.0	51.2	50.7	< 0.0001
Elective	45.9	46.9	42.6	42.2	44.3	45.3	46.5	48.0	48.8	49.3	< 0.0001
Disposition Status (%)
Home	72.0	70.9	72.8	73.5	73.4	73.9	74.0	75.2	76.0	76.2	< 0.0001
Facility	17.5	18.6	18.1	18.0	18.3	17.6	18.0	17.6	16.9	16.1	< 0.0001
Mortality	10.1	9.8	8.6	7.9	7.9	8.1	7.7	7.0	6.9	7.6	< 0.0001
Mean Length of Stay	8.4	8.1	8.2	8.0	7.8	7.6	7.5	7.3	7.1	7.0	< 0.0001

Table: Biodemographic characteristics and outcomes of pancreatic cancer hospitalizations in the United States from 2008 to 2017.

Disclosures:

Asim Kichloo indicated no relevant financial relationships.

Dhanshree Solanki indicated no relevant financial relationships.

Dushyant Dahiya indicated no relevant financial relationships.

Jagmeet Singh indicated no relevant financial relationships.

Khwaja Haq indicated no relevant financial relationships.

Manasee Vyas indicated no relevant financial relationships.

Shantanu Solanki indicated no relevant financial relationships.

Mohammad Al-Haddad indicated no relevant financial relationships.

Asim Kichloo, MD¹, Dhanshree Solanki, MHA², Dushyant S. Dahiya, MD¹, Jagmeet Singh, MD³, Khwaja F. Haq, MD⁴, Manasee Vyas, MBBS⁵, Shantanu Solanki, MD, MPH⁶, Mohammad Al-Haddad, MD⁷. P2113 - Pancreatic Cancer: An Overview of National Trends and Adverse Outcomes in the United States From 2008 to 2017, ACG 2021 Annual Scientific Meeting Abstracts. Las Vegas, Nevada: American College of Gastroenterology.