Mortality and other outcomes of hospitalizations due to pancreatic cancer.
Authors: Zengin Bugra , Zahid Zaid , Alqaisieh Mohammad , Singh Sneha , Duhaime Lisa A. 
Published: January 2025

780

Background:
Pancreatic cancer continues to be a highly fatal malignancy of the digestive system and imposes a significant financial strain on healthcare systems. Although it is often diagnosed incidentally, several risk factors have been identified, including smoking, family history, age, race, gender, and alcohol use. In this study, we aimed to examine inpatient outcomes and the healthcare burden of patients hospitalized with pancreatic cancer.
Methods:
Patients admitted to the hospital in 2019 and 2020 were identified using the Nationwide Inpatient Sample database and categorized into two groups based on the presence of a pancreatic cancer diagnosis (with relevant ICD-10 codes). To account for confounding factors, multivariate regression analysis was applied when calculating mortality. Statistical analyses were conducted to assess mortality rates, length of stay and hospital charges.
Results:
:
A total of 74,584 patients met the inclusion criteria, with a mean age of 68.5 years. The majority were white (69%), while black patients made up 13% of the study population, and 49% were female (36,570 patients). Thrombosis (OR: 2.08, p < 0.001), age over 60 (OR: 1.22, p = 0.042), and being of black race (compared to white race, OR: 1.45, p = 0.001) were linked to higher mortality rates. Thrombosis was also associated with longer hospital stays (+1.9 days, p<0.001) and increased costs (+$16,003, p= 0.001). However, age over 60 (+0.26 days, p = 0.088; +$589, p = 0.833) and black race (+1.01 days, p< 0.001; +$1,493.7, p = 0.649) showed trends toward longer stays and higher costs, these were not statistically significant. On the other hand, pancreatic conditions such as chronic pancreatitis, pancreatic cysts, pseudocysts, or exocrine pancreatic insufficiency (OR: 0.589, p < 0.001), female gender (OR: 0.78, p = 0.002), and care at urban teaching facilities (OR: 0.37, p < 0.001) were associated with lower mortality. While female gender (+0.06 days, p=0.603; -$1699, p=0.448) did not significantly impact hospital length of stay or costs, pancreatic disease (+0.33 days, p = 0.031; +$10,826, p < 0.001) and being treated at urban teaching facilities (+1.8 days, p < 0.001; +$57,106, p < 0.001) were linked to longer stays and higher costs.
Conclusions:
Although some unmodifiable risk factors significantly increase mortality, thrombosis contributes not only to higher mortality but also to increased healthcare costs and longer hospital stays. However, it may be preventable with anticoagulation therapy. The inverse relationship between pancreatic disease and mortality could potentially be explained by more frequent imaging and earlier detection of malignancies in these patients.

Analysis of factors influencing in-hospital mortality, length of hospital stay, and total charges in hospitalized patients.

Data
Mortality
Length of hospital stay
Total Charge

Age>60
1.22(p=0.042)
+0.26 days, p=0.088
$589, p=0.833

Race (black compared to white race)
1.45 (p=0.001)
+1.01 days, p< 0.001
$1493.7, p=0.649

Female gender
0.78 (p=0.002)
+0.06 days, p=0.603
-$1699, p=0.448

Treatment at urban teaching facility
0.37(p<0.001)
+1.8 days, p<0.001
$57,106, p<0.001

Thrombosis
2.08(p<0.001)
+1.9 days, p< 0.001
$16,003, p= 0.001

Pancreatic conditions
0.589(p<0.001)
+0.33 days, p= 0.031
$10,826, p<0.001