In-Hospital Mortality and Post-Surgical Complications Among Cancer Patients with Metabolic Syndrome

Authors:

Swati Sakhuja (Presenter)
University of Alabama at Birmingham School of Public Health

Tomi Akinyemiju, University of Alabama at Birmingham School of Public Health
Neomi Vin-Raviv, School of Social Work Colorado University

Public Health Statement: Metabolic Syndrome (MetS) is an important etiologic and prognostic factor for cancer, but few studies have assessed hospitalization outcomes among patients with both conditions.

Purpose: To examine in-hospital mortality, post-surgical complications and hospital length of stay, among hospitalized cancer patients with a clinical diagnosis of MetS.

Methods/Approach: Data from the Healthcare Cost and Utilization project Nationwide Inpatient Sample (HCUP-NIS) was used to identify ICD-9 codes on adults aged 40 years and over admitted to a U.S. hospital between 2007 and 2011 with primary diagnosis of either breast, colorectal or prostate cancer. Descriptive statistics was conducted to assess the proportion of cancer patients with MetS. Multivariable regression analysis was done in order to examined in-hospital mortality, post-surgical complications and discharge disposition among cancer patients with MetS, and compared with non-MetS patients.

Results: Hospitalized breast (OR: 0.31, 95% CI: 0.20–0.46), colorectal (OR: 0.41, 95% CI: 0.35–0.49) and prostate (OR: 0.28, 95% CI: 0.16–0.49) cancer patients with MetS had significantly reduced odds of in-hospital mortality. The odds of post-surgical complications among breast (OR: 1.20, 95% CI: 1.03–1.39) and prostate (OR: 1.22, 95% CI: 1.09–1.37) cancer patients with MetS were higher, but lower by 7% among colorectal cancer patients with MetS. Additionally, breast (OR: 1.21, 95% CI: 1.11–1.32) and colorectal (OR: 1.06, 95% CI: 1.01–1.11) cancer patients with MetS had significantly higher odds for discharge to a skilled nursing facility compared with those without MetS.

Conclusions/Implications: Clinical diagnosis of MetS significantly increases the odds of post-surgical complications and discharge to a skilled nursing facility among breast and prostate cancer patients. The observed reduced odds of in-hospital mortality is likely due to increased likelihood of discharge to skilled nursing facilities.