Admission acuity and inpatient outcomes among hospitalizations for pancreatic cancer in the United States, 2018–2022.

Abstract

e16352 Background: Pancreatic cancer is associated with high morbidity and frequent hospitalization. National data describing the association between admission acuity and inpatient outcomes in pancreatic cancer hospitalizations remain limited. Methods: A serial cross-sectional analysis was conducted using the 2018–2022 Healthcare Cost and Utilization Project National Inpatient Sample. Adult hospitalizations with a principal diagnosis of pancreatic cancer were identified. Admission acuity was classified as elective or non-elective. Outcomes included in-hospital mortality (primary), length of stay (LOS), and hospitalization cost estimated using cost-to-charge ratios. National estimates accounted for survey weighting, clustering, and stratification. Survey-weighted multivariable logistic regression evaluated factors independently associated with in-hospital mortality, adjusting for admission type, age, sex, race, payer, neighborhood income quartile, hospital teaching status, and calendar year. Results: From 2018–2022, an estimated 188,750 pancreatic cancer hospitalizations were identified nationally. Overall, 69.6% of hospitalizations were non-elective. In-hospital mortality was higher among non-elective than elective admissions (6.30% vs 3.44%), with longer LOS (7.97 vs 6.47 days) and lower mean hospitalization costs ($21,217 vs $41,231). In adjusted analyses, elective admission was independently associated with lower odds of in-hospital mortality compared with non-elective admission (adjusted odds ratio 0.55, 95% CI 0.41–0.73; p < 0.001). Conclusions: Among pancreatic cancer hospitalizations, non-elective admission was associated with substantially higher inpatient mortality and longer length of stay independent of patient and hospital characteristics. These nationally representative findings provide benchmarking data for admission acuity as a marker of inpatient risk in pancreatic cancer.