Prevalence and outcomes of lung abscess in hospitalized lung cancer patients: Insights from the Nationwide Inpatient Sample.

Abstract

e20067 Background: Lung abscess is a common complication of pneumonia, frequently associated with significant morbidity. In lung cancer patients, abscess formation is often linked to tumor-induced bronchial obstruction, post-obstructive infections, or impaired immunity, further complicating treatment and potentially impacting outcomes. This study explores the impact of lung abscesses on inpatient outcomes in this population, addressing an important gap in the current literature. Methods: We analyzed data from the 2019 National Inpatient Sample to identify patients diagnosed with lung cancer using ICD-10 codes. The cohort was categorized into two groups: those with lung abscess and those without. Sociodemographic characteristics and comorbidities were compared between the groups. The primary outcome was all-cause in-hospital mortality, while several secondary outcomes were also evaluated. Multivariate regression models were applied to assess outcome differences between the groups, with statistical significance defined as p < 0.05. Results: Among 317,180 adult patients hospitalized with lung cancer, 1,375 (0.43%) were diagnosed with a lung abscess during their hospitalization. These patients were younger on average (mean age: 65.3 years vs. 69.6 years, p < 0.001) and had a higher proportion of males (64.3%) compared to females (35.7%). Lung cancer patients with a lung abscess exhibited significantly increased odds of all-cause mortality (adjusted odds ratio [aOR]: 1.67; 95% confidence interval [CI]: 1.20–2.03; p = 0.002), septic shock (aOR: 2.47; 95% CI: 1.69–3.61; p < 0.001), and sudden cardiac death (aOR: 3.60; 95% CI: 2.01–6.43; p < 0.001). Additionally, these patients experienced longer hospital stays (mean length of stay: 9.7 days vs. 6.1 days; p < 0.001) and incurred higher hospitalization costs ($112,510 vs. $69,080; p < 0.001). No significant differences were observed in the odds of pulmonary embolism or acute kidney injury between the two groups. Conclusions: Lung cancer patients with concurrent lung abscess had notably increased odds of mortality, sudden cardiac arrest, and septic shock, along with prolonged hospital stays and elevated hospitalization costs, compared to those without a lung abscess. These findings highlight the need for focused management strategies to mitigate the adverse effects of lung abscess on outcomes in this patient group.