Risk factors for in-hospital mortality in patients with ...

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1Department of Epidemiology, College for Public Health and Social Justice, Saint Louis. University, St. Louis, MO, USA. 2Center for Outcomes Research ...
Risk factors for in-hospital mortality in patients with malignant solid tumors: a nationwide analysis

Kahee A. Mohammed1, 2, Eric Adjei2, Nosayaba Osazua-Peters3, 4, Leslie Hinyard2, Paula Buchanan2, Lauren D. Arnold1 1Department of Epidemiology, College for Public Health and Social Justice, Saint Louis University, St. Louis, MO, USA 2Center for Outcomes Research (SLUCOR), Saint Louis University, St. Louis, MO, USA 3Saint Louis University Cancer Center, Saint Louis, MO, USA 4Saint Louis University, School of Medicine, Department of Otolaryngology-Head and Neck Surgery, St. Louis, MO, USA

OBJECTIVE: The study aimed to identify risk factors associated with in-hospital mortality among patients with malignant solid tumors. METHODS: Using data from the Nationwide Inpatient Sample 2012, we identified patients (n=330,871) with at least one diagnosis of malignant solid tumor using the International Classification of Diseases, ninth edition, Clinical Modification (ICD-9-CM Codes). Weighted multivariate logistic regression analysis was performed to examine risk factors associated with in-hospital mortality. RESULTS: The overall in-hospital mortality rate was 5.6%. Approximately 26% (n=87,459) had metastatic disease with a mortality rate of 37%. Compared to patients with lung cancer, lower odds of mortality were noted in patients with any type of solid tumor (p85 years (OR = 1.48, 95% CI = 1.38–1.58)], male sex (OR = 1.27, 95% CI = 1.22–1.33), Asian race (OR = 1.36, 95% CI = 1.22–1.51), and lower household income – $1 - $38,999 (OR = 1.09, 95% CI = 1.04 – 1.15). In addition, increasing Elixhauser comorbidity score (OR = 1.19 per 1 unit increase, 95% CI = 1.18 -1.20), admission to a nonteaching (OR = 1.15, 95% CI = 1.11 - 1.19) and small hospitals (OR = 1.07, 95% CI = 1.02 – 1.14), and admission on a weekend (OR = 1.29, 95% CI = 1.24 – 1.35) were associated with inhospital mortality. Moreover, cancer patients admitted to hospitals in Midwest, South, and West were less likely to be deceased in the hospital compared to their peers in Northeast hospitals (p