The association of obesity in hospitalized pancreatic cancer patients: A nationwide analysis.

Abstract

e16435 Background: Pancreatic cancer is the 10th most common cancer among males and the 8th most common cancer for females in the United state. Obesity is a major risk factor for pancreatic cancer. However, the role of obesity in inpatient mortality among pancreatic cancer patients has not been extensively examined. This study explores the mortality rates of hospitalized pancreatic cancer patients with obesity and without obesity. Methods: Using the National Inpatient Sample (2018–2022), we identified adult patients hospitalized with a primary diagnosis of pancreatic cancer. Patients were stratified by metastatic versus non-metastatic disease and by obesity status (obese versus non-obese). The primary outcome was mortality. Secondary outcomes included length of stay (LOS), total hospital charges, and palliative care encounters. Multivariate logistic regression analysis was used to adjust for confounders. Results: A total of 131,685 patients were hospitalized with a primary diagnosis of pancreatic cancer, of whom 62,794.98 had non-metastatic disease and 68,889.99 had metastatic cancer. Among these patients, 11% were obese, while 89% were non-obese. Additionally, 54.17% of females were obese compared to 45.83% of males (p < 0.0001). The mean age of non-obese patients was 69.38 years (95% CI: 69.22-69.55), while obese patients were younger, with a mean age of 66.95 years (95% CI: 66.56-67.35, p < 0.0001 ). There were approximately 8,290 deaths (95% CI: 7,863.28–8,716.73) among these patients, of which 71% had metastatic cancer and 29% had non-metastatic cancer. After adjusting for confounders, obesity was associated with significantly lower odds of death among hospitalized pancreatic cancer patients (OR = 0.61, 95% CI: 0.51–0.72, p < 0.001). Female patients had significantly lower odds of mortality compared to male (OR = 0.87, 95% CI: 0.77-0.98, p < 0.032), while African American patients had increased mortality compared to White patients (OR = 1.19, 95% CI: 1.01-1.40, p > 0.032). Obesity was not significantly associated with increased LOS (p= 0.451), although it was associated with higher total hospital charges in hospitalized pancreatic cancer patients (β = 5,091.917, p < 0.001) after adjusting for confounders. Additionally, obese patients were less likely to have palliative care encounters compared to non-obese patients (OR = 0.57, 95% CI: 0.52-0.62, p < 0.001). Conclusions: Obesity in hospitalized pancreatic cancer patients was associated with lower odds of mortality, increased hospital charges, and decreased palliative care utilization. These findings suggest that obesity may have a complex, protective effect on survival in hospitalized patients, warranting further investigation to understand the underlying mechanisms and its clinical implications. Association between obesity and pancreatic cancer. Odds Ratio P Value 95% Confidence Interval Primary Outcome Mortality 0.6094746 p <0.001 .5111609 - .7266974 Secondary Outcome Length of Stay (LOS) 0.0983923 P=0.451 .3541148 - .1573303 Total Charges 5091.917 p <0.001 2349.202 - 7834.632 Palliative Care Encounters 0.5795194 p <0.001 0.5229095 - .6422579