P0007 - Gender Disparity in Trending the Inpatient Mortality Rate of Pancreatic Cancer: A Nationwide Cohort Study 2004-2014

Nooraldin Merza, MD¹, Brian P. Rutledge, MD², Wissam Kiwan, MD³, Bashar Mohamad, MD^4
1Wayne State University, Dearborn, MI; ²Wayne State University, Detroit Medical Center, Detroit, MI; ³Wayne State University, Detroit, MI; ⁴Wayne State University School of Medicine, Detroit, MI

Introduction: Pancreatic cancer is a common and highly fatal malignancy. It is the fourth most frequent cause of cancer death after lung, breast/prostate, and colorectal cancer. Although it is the fourth leading cause of cancer death, few studies have evaluated population-based trends in diagnosis, mortality rate, gender variation in trending, and outcome

Methods: A retrospective analysis utilizing the de-identified data from the National Inpatient Sample (NIS) was used to analyze patients hospitalized with pancreatic cancer as a primary admission diagnosis from 2004 through 2014. Hospital encounters for pancreas cancer were identified using the International Classification of Diseases (ICD-9) codes; '157.9' '157.4' '156.2' '157.0' '157.1' '157.2' '157.3' '157.4. The NIS is a component of the Healthcare Cost and Utilization Project, a national health care database developed through a partnership among federal and state governments and health care institutions sponsored by the Agency for Healthcare Research and Quality. In addition, we extracted baseline medical and demographic data, including age, race, income, insurance status, and trending of inpatient mortality rate based on their gender were demonstrated through the graphs. Categorical variables were compared using the chi-square test, and continuous variables were compared using the t-test. P-values less than 0.05 indicated a statistically significant association. The odds ratio and 95% confidence interval were also calculated

Results: Total of 177,763 patients with a principal diagnosis of pancreatic cancer obtained through data analysis (2004 through 2014). The majority of the patients' age was between 65 and 79 years (42.2%; P< 0.001), 0.7% were younger than 35 years, 6.6% (35-49 years), 31.0% (50-64 years), and 19.5% were older than 79 years. In addition, 50.9% (90,498) of the patients were males, and white 74.4% (113392). Interestingly, trends of the mortality rate for hospitalized individuals with pancreatic cancer decreased from 12.2% (in 2004) to 7.61% (in 2014) and, based on gender stratification mortality rate, was consistently higher in male sex (in 2004 was 12.5% vs. 11.8%, and in 2014 was 8.38% vs. 6.80%)

Discussion: A large database was used for trending temporal changes of hospitalization data and survival of patients with pancreatic adenocarcinoma. The mortality rate for hospitalized individuals with pancreatic cancer decreased consistently. Gender stratification of the inpatient mortality rate was consistently higher in males


Figure: Average and gender stratified in-hospital mortality rate for pancreatic cancer from 2004 through 2014

Demographic characteristic	Percentage	P-Value
N	177763
Age
Less than 35	1196 (0.7)	< 0.001
35-49	11765 (6.6)	< 0.001
50-64	55069 (31.0)	< 0.001
65-79	75079 (42.2)	< 0.001
>79 years	34633 (19.5)	< 0.001
Female (%)	87265 (49.1)	< 0.01
Race
White	113392 (74.4)	< 0.001
African American	19040 (12.5)	< 0.001
Hispanic	11165 (7.3)	< 0.001
Asian	4420 (2.9)	< 0.001
Native American	599 (0.4)	< 0.001
Others	3818 (2.5)	< 0.001
Income Quartile
Quart 1	43422 (24.9)	0.02
Quart 2	43334 (24.9)	< 0.001
Quart 3	42942 (24.7)	< 0.001
Quart 4	44395 (25.5)	< 0.001
Insurance Status
Medicare	103166 (58.1)	< 0.001
Medicaid	12608 (7.1)	< 0.001
private Insurance	52732 (29.7)	< 0.001
Self-Pay	4033 (2.3)	< 0.001
No charges	493 (0.3)	< 0.001
Others	4396 (2.5)	< 0.001

Table: Baseline demography of patients with pancreatic cancer in the NIS 2004-2014


Disclosures:
Nooraldin Merza indicated no relevant financial relationships.
Brian Rutledge indicated no relevant financial relationships.
Wissam Kiwan indicated no relevant financial relationships.
Bashar Mohamad indicated no relevant financial relationships.


Nooraldin Merza, MD¹, Brian P. Rutledge, MD², Wissam Kiwan, MD³, Bashar Mohamad, MD⁴. P0007 - Gender Disparity in Trending the Inpatient Mortality Rate of Pancreatic Cancer: A Nationwide Cohort Study 2004-2014, ACG 2021 Annual Scientific Meeting Abstracts. Las Vegas, Nevada: American College of Gastroenterology.