Impact of alcohol use disorder on outcomes in gastrointestinal cancer patients: A National Inpatient Sample analysis.

Abstract

e16485 Background: Alcohol is not only known to be a risk factor for many gastrointestinal malignancies but also affects its management and outcomes. The specific impact of alcohol use disorder (AUD) on GI cancers remains understudied. We aimed to conduct a retrospective database study using the National inpatient sample (NIS) database to identify potential differences in outcomes in this population. Methods: We queried the NIS database from 2016 to 2021 using ICD-10 codes to identify individuals aged above 18 years with alcohol use disorder and GI malignancies (esophagus, stomach, small intestine, colorectal, liver, biliary, pancreatic, spleen). We compared baseline characteristics and analyzed outcomes using logistic regression analysis among two cohorts (GI malignancies with AUD and without AUD). Results: Our analysis identified 104795 patients with GI malignancies and AUD (GI+AUD) and 2656104 patients with GI malignancies but without AUD (GI-AUD). Males were higher in the GI+AUD group (83%) as compared to the GI-AUD group (57%). Racial distribution among GI+AUD vs GI-AUD was comparable i.e Whites (61% vs 68%), African Americans (17% vs 13%), Hispanics (15% vs 11%), Asians (2% vs 4%). Higher percentage of individuals i.e 61% vs 53% belonged to < 35,000/annum USD income group in the GI+AUD group compared to GI-AUD group. Odds of mortality were significantly higher in the GI+AUD group OR 1.19 (p < 0.05; 95% CI 1.13 - 1.26). Acute liver failure was also significantly higher in GI+AUD OR 4.54 (p < 0.05; 95% CI 4.37 - 4.72) when compared to the GI-AUD group. GI+AUD also had significantly higher odds for mechanical ventilator use OR 1.46 (p < 0.05; 95% CI 1.37 - 1.56), acute renal failure OR 1.23 (p < 0.05; 95% CI 1.19 - 1.27), and shock OR 1.55 (p < 0.05; 95% CI 1.44- 1.67). Mean length (6.83 vs 6.51 days) of stay and inpatient stay charges ($84958 vs $84479) were comparable among GI+AUD and GI-AUD groups respectively. Conclusions: Our study identified significantly worse overall outcomes such as mortality and severe complications including ventilator use, renal failure, liver failure, and shock in individuals with alcohol use disorder and GI malignancies. Further efforts to raise awareness, confirm the findings, improve care, and mitigate adverse outcomes in this vulnerable population is warranted.