Abstract 496P
Background
The outcomes of in-hospital cardiopulmonary resuscitation (ICPR) in cancer patients was worse than general population. Certain cancer types were also identified as poor prognostic factors. We aim to investigate the impact of colorectal cancer (CRC), the third most common cancer in the US, in the outcomes of ICPR, which are relatively unknown.
Methods
This is a retrospective analysis of the US National Inpatient Sample database (2016-2018) including adults (age at least 18-year-old) with ICPR. International Classification of Diseases, 10th Revision, Clinical Modification codes were used to identify the procedure (e.g., ICPR) and diagnosis (e.g., CRC), respectively. Primary outcome was mortality. The covariates were analyzed with the generalized linear model.
Results
A total of 67,351 ICPR-associated hospitalizations were identified. Among them, 7,008 records had at least one cancer diagnosis and 929 of them were CRC. The mortality was higher in CRC than non-CRC patients (82.2% vs 68.6%, adjusted odds ratio [aOR]: 1.77, p<10-9) after adjusting for covariates including comorbidities. Among cancer patients, CRC subgroup had a trend of higher mortality (aOR: 1.18, p<0.1). There was higher risk of severe sepsis in CRC subgroup than other cancer patients (aOR: 1.28, p<0.005). Utilization of palliative care of CRC-associated hospitalizations was higher (aOR: 1.30, p<0.002) compared to non-CRC patients; nevertheless, there was no significant difference between CRC and non-CRC cancer cases (p>0.8). The total charges and length of stay were lower in CRC patients but not statistically different.
Conclusions
CRC was associated with lower survival rate after ICPR. Among cancer patients, CRC subgroup had an unfavorable trend of higher mortality. CRC patients were also found with higher risk of severe sepsis than non-CRC cancer patients due to unknown reason. Despite the trend of worse prognosis, CRC patients did not have higher palliative care utilization when compared to non-CRC cancer counterparts. The unfavorable prognosis associated with CRC should be acknowledged when discussing the code status and goal of care before and after ICPR.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.