P2098 - Healthcare Utilization and Outcomes in HIV vs Non-HIV Patients With Pancreatic Cancer: A Retrospective Cohort Study

Garima Pudasaini, MD¹, Ikechukwu Achebe, MD¹, Kapil Chhetri, MD¹, Jennifer Asotibe, MD¹, Hla Wai, MD², Muhammad Sheharyar Warraich, MD^1
1John H. Stroger, Jr. Hospital of Cook County, Chicago, IL; ²Stroger, Chicago, IL

Introduction: Pancreatic Cancer (PC) is the fourth leading cause of cancer-related mortality in the United States and has a five-year survival after pancreaticoduodenectomy reaching 10%. HIV is not known to directly affect PC, but chronic immunosuppression and effects of HIV on pancreatic parenchyma may contribute to the pathogenesis of carcinomas. We studied differences in outcomes and healthcare utilization between HIV and non-HIV-PC from a national database.

Methods: We identified adults with PC, with and without HIV (2016-2018) using the Healthcare Cost Utilization Project (HCUP)’s National Inpatient Sample (NIS) database. Groups were compared for demographic differences, inpatient mortality, length of stay (LOS) and total hospital charges (THC). Secondary outcomes were rate of acute kidney injury (AKI), anemia, sepsis, septic shock (SS), neutropenia, and protein-energy malnutrition (PEM). Statistics were performed using the t-test, univariate and multivariate logistic regression with Stata software.

Results: 470 inpatient admissions with PC-HIV and 207,499 with non-PC-HIV were identified. PC-HIV patients were significantly younger (mean age 59.9 vs 68.1 years, p< 0.0001) with a reduced percentage of patients over 65 years (34.0% vs 62.3%, p< 0.0001), more men (72.3% vs 52.1%, p < 0.0001), more African American (AA) (57.8% VS 13.9%, p< 0.0001), frequently treated at a teaching hospitals (84.0% vs 74.8%, p< 0.040), and had higher comorbidity burden as defined by Charlson-comorbidity index score (score above 3; 100% vs 84.8%, p< 0.0001) compared to the non-PC-HIV cohort. PC-HIV patients had significantly lower odds of inpatient mortality (aOR= 0.42, CI= 0.19 – 0.92, p = 0.031), but had longer LOS (7.52 vs 6.09, p=0.0034) and THC (80,140 vs 66,361 p=0.047). PC-HIV patients had higher odds of septic shock (10.6% vs 5.86%, p< 0.05) and PEM (36.2% vs 24.3%, p=0.01). Rates of AKI, anemia, and sepsis were similar between groups.

Discussion: Patients with PC-HIV are more likely younger, AA, and men with significantly lower inpatient mortality compared to non-PC-HIV. Despite higher rates of PEM and septic shock, PC-HIV patients being younger and overwhelmingly (84.0%) treated at teaching hospitals may be contributing to the observed lower mortality. However, the HIV-PC cohort was a high inpatient healthcare utilizer with significantly increased length of stay and hospitalization cost. Prospective studies are needed to further investigate and reduce complications of PEM and septic shock in this cohort.


Disclosures:
Garima Pudasaini indicated no relevant financial relationships.
Ikechukwu Achebe indicated no relevant financial relationships.
Kapil Chhetri indicated no relevant financial relationships.
Jennifer Asotibe indicated no relevant financial relationships.
Hla Wai indicated no relevant financial relationships.
Muhammad Sheharyar Warraich indicated no relevant financial relationships.


Garima Pudasaini, MD¹, Ikechukwu Achebe, MD¹, Kapil Chhetri, MD¹, Jennifer Asotibe, MD¹, Hla Wai, MD², Muhammad Sheharyar Warraich, MD¹. P2098 - Healthcare Utilization and Outcomes in HIV vs Non-HIV Patients With Pancreatic Cancer: A Retrospective Cohort Study, ACG 2021 Annual Scientific Meeting Abstracts. Las Vegas, Nevada: American College of Gastroenterology.