E0091 - Trends of LOS, Mortality and Healthcare Costs in Comparison With Colorectal Cancer, Breast Cancer and Lung Cancer

Tuesday, October 25, 2022

3:00 PM – 5:00 PM ET

Location: Crown Ballroom

Has Audio

Presenting Author(s)

SG

Swathi Gopishetty, MD

Geisinger Health System
Wilkes-Barre, Pennsylvania

Swathi Gopishetty, MD¹, Birendra Amgai, MD², Lekha Yadukumar, MD³, Sriram B. Chowdary, MD², Moe Samour, MD¹, Raghava Reddy Levaka Veera, MD¹
¹Geisinger Health System, Wilkes-Barre, PA; ²Geisinger Health System, Scranton, PA; ³The Wright Center for GME, Scranton, PA

Introduction: Febrile neutropenia is a life-threatening side effect with the mortality of 5 to 11% and can exceed up to 50% in high-risk patients. The objective is to evaluate its effect on mortality, length of stay, health care costs involved with colon cancer in comparison with lung and breast cancer due to its increasing clinical and economic burden. It also involves modifications in the chemotherapy regimen.

Methods: A retrospective study was conducted in adults >18 years using the Nationwide Inpatient Sample (NIS) database from 2016 to 2019 with the admitting diagnosis of Febrile Neutropenia in hospitalized patients with colorectal, breast and lung cancer using the ICD 9 and ICD 10 codes. Study was focused on its effect on mortality, length of stay, co-morbidities, insurance status and health care costs involved based on the cancer type. The outcome was analyzed using multivariate logistic regression analysis and statistical analysis was done using STATA.

Results: Among 7550 colorectal cancer patients, the mean hospital length of stay (LOS) was 6.2 days which is higher than breast cancer (4.5 days) and almost like lung cancer (6.2 days). The mean total health care costs were $16,272 for colorectal cancer whereas it is $11,609 and $17,503 for breast and lung cancer respectively. The in-patient mortality rate was 4% for colorectal and is 1.6% for breast and 6.5% for lung cancer. The odds ratio of in-patient mortality for lung cancer compared to colorectal cancer is 1.10 (with the p-value of 0.020 and confidence interval of 1.01 to 1.20), breast cancer in comparison to colorectal cancer is 0.67 (with p-value of < 0.001 and confidence interval of 0.59 to 0.75) and lung cancer in comparison to breast cancer is 0.99 (with p-value 0.84 and confidence interval of 0.90 to 1.08). The charlson Co-morbidity index was >3 in 75% in colorectal cancer whereas it is >3 in 58% and 85% in breast and lung cancer population.

Discussion: Increase in mean length of stay was observed in colorectal cancer compared to breast cancer and increased health care costs for colorectal cancer was also observed despite its lower incidence than breast and lung cancer. The co-morbidity risk and in-patient mortality rate for colorectal cancer is higher than breast cancer.

Metric	Colorectal cancer	Breast cancer	Lung cancer

Total Population	7550	19915	15465
Mean Age	61.8±12.2	57.7±12.5	66.3±11.2
Female (%)	56.7	100	49.0
Race
White (%)	75	72	82
Non-White (%)	25	28	18
Charlson Co-morbidity (%)
0-2	24.8	42.2	14.4
3 or >3	75.2	57.8	85.6
Chronic co-morbidities
Anemia	7.4	3.4	2.7
Congestive Heart failure	4.8	4.0	10.9
Arrythmia	15.8	11.4	26.4
Peripheral Vascular disease	4.6	3.0	9.0
Chronic Lung disease	12.3	13.6	50.5
Obesity	7.2	11.2	6.6
Hypothyroidism	11.2	15.5	12.4
Chronic Kidney disease	8.9	5.1	12.5
HTN	47.6	43.8	60.5
Diabetes Mellitus	15.5	16.6	21.1

In-Patient Mortality rate	4.0	1.6	6.5
Mean Length of stay (days)	6.2±5.9	4.5±4.4	6.2±5.7
Mean total cost (dollars)	16272	11609	17503

In-patient Mortality	Odds ratio	P Value	95% CI
Breast ca comparison to colorectal ca	0.67	< 0.001	0.59-0.75
Lung ca comparison to colorectal ca	1.10	0.020	1.01-1.20
Lung Ca comparison to breast Ca	0.99	0.84	0.90-1.08

Table: Comparison between Colorectal, Breast and Lung Cancer Studies

Disclosures:

Swathi Gopishetty indicated no relevant financial relationships.

Birendra Amgai indicated no relevant financial relationships.

Lekha Yadukumar indicated no relevant financial relationships.

Sriram Chowdary indicated no relevant financial relationships.

Moe Samour indicated no relevant financial relationships.

Raghava Reddy Levaka Veera indicated no relevant financial relationships.

Swathi Gopishetty, MD¹, Birendra Amgai, MD², Lekha Yadukumar, MD³, Sriram B. Chowdary, MD², Moe Samour, MD¹, Raghava Reddy Levaka Veera, MD¹. E0091 - Trends of LOS, Mortality and Healthcare Costs in Comparison With Colorectal Cancer, Breast Cancer and Lung Cancer, ACG 2022 Annual Scientific Meeting Abstracts. Charlotte, NC: American College of Gastroenterology.