Gender disparities in major adverse cardiovascular and cerebrovascular events among liver cancer patients: A nationwide analysis (NIS 2016–2021).

Abstract

e16271 Background: Liver cancer poses a major global health burden, with gender differences influencing outcomes & cardiovascular risks. This study examines disparities in MACCE, in-hospital mortality, & healthcare costs among hospitalized liver cancer patients using NIS data from 2016–2021. Methods: A retrospective cohort study using NIS data (2016–2021) identified adult liver cancer patients, stratified by gender. Primary outcomes included MACCE, in-hospital mortality, MI, stroke, A-fib, and sudden cardiac arrest, while secondary outcomes were length of stay (LOS) and total charges (TOTCHG). Multivariable logistic regression adjusted for confounders to assess gender-based differences. Results: Among 351,509 liver cancer patients, 72.8% were male, and 27.2% were female. Males had a significantly higher prevalence of sudden cardiac arrest (1.37% vs. 1.00%, p < 0.001) and A-fib (10.64% vs. 9.73%, p = 0.0009) compared to females. However, males had a lower prevalence of obesity (9.24% vs. 12.99%, p < 0.001) and chronic obstructive pulmonary disease (18.72% vs. 20.67%, p < 0.001). Mortality rates were higher in males (9.99% vs. 8.49%, p < 0.001), while females had higher rates of stroke (0.96% vs. 0.80%, p = 0.0353). Males had a significantly lower risk of MI (OR 0.874, p = 0.031), cerebral artery stenosis (OR 0.718, p = 0.012), and sudden cardiac arrest (OR 0.743, p < 0.001). However, males had a higher but non-significant trend toward intracranial hemorrhage (OR 1.223, p = 0.054). There was no significant difference in acute congestive heart failure (OR 0.954, p = 0.779). LOS was slightly longer for males compared to females (β = 0.182 days, p = 0.005), but total hospital charges were not significantly different between genders (β = $1,350.60, p = 0.427). Conclusions: This study highlights gender disparities in liver cancer, with higher mortality in males and greater stroke risk in females. Gender-specific strategies are needed to improve outcomes. Outcome Odds Ratio 95% confidence P value Death 0.856 0.806 0.908 <0.001 MI 0.874 0.773 0.987 0.031 Cerebral Artery Stenosis 0.718 0.55 0.931 0.012 Stroke 1.16 0.966 1.394 0.112 Sudden Cardiac 0.743 0.631 0.874 <0.001 A Fib 0.779 0.733 0.829 <0.001 Arrythmia 0.804 0.686 0.943 0.007 ICH 1.223 0.996 1.501 0.054 Acute CHF 0.954 0.687 1.324 0.779 LOS 0.182 0.056 0.309 0.005 Total Health Charges 1350.6 -1983.7 4684.8 0.427