Cardiovascular comorbidity burden and in-hospital outcomes in patients with lung cancer: A retrospective analysis.

Abstract

e20111 Background: Patients with lung cancer have the highest prevalence of pre-existing cardiovascular disease and face the greatest risk of cardiovascular events following diagnosis. In addition, lung cancer therapies may exacerbate underlying cardiac comorbidities. Therefore, we wanted to evaluate the prevalence of cardiovascular disease among patients hospitalized with lung cancer and assess its impact on in-hospital mortality. Methods: We conducted a retrospective analysis of the National Inpatient Sample (NIS) from 2016–2020. Adult hospitalizations with a primary diagnosis of lung cancer were identified using ICD-10-CM codes, and cardiac comorbidities were captured from secondary diagnosis fields. Categorical variables were compared using the chi-square test, and continuous variables using the Student’s t-test. Multivariable regression models were used to adjust for potential confounders and to estimate adjusted odds ratios (aORs). A two-sided p value < 0.05 was considered statistically significant. Results: A total of 200,6760 patients were hospitalized with a primary diagnosis of lung cancer. The prevalence of cardiac risk factors was higher among older adults. The mean age of patients admitted with lung cancer was 69 years. Of these patients, 48% were female and 52% were male. Among the total cohort, 17% had congestive heart failure (CHF), 25% had coronary artery disease (CAD), 12% had atrial fibrillation, 2% had ventricular arrhythmias, and 0.08% had endocarditis. Overall, in-hospital mortality was higher among patients with these cardiac risk factors.On multivariable regression analysis, the presence of cardiac comorbidities remained significantly associated with increased odds of mortality. CAD was associated with increased mortality (aOR 1.9, p = 0.001), as were CHF (aOR 1.3, p < 0.001) and atrial fibrillation (aOR 1.15, p < 0.001). Ventricular arrhythmias and endocarditis showed the strongest associations, each with an aOR of 2.3 (p < 0.001). Conclusions: In this analysis, cardiovascular co-morbidities were highly prevalent among patients with lung cancer. The presence of baseline cardiovascular co-morbidities can worsen outcomes. Early recognition these risk factorsmay reduce adverse events, improve clinical outcomes, and enhance overall quality of life for patients with lung cancer. In-hospital mortality among patients hospitalized with lung cancer stratified by cardiac comorbidities. Cardiac Risk factors Mortality in lung cancer patients Percentage Adjusted Odds ratio P-value Congestive heart failure 38169/334569 11% 1.3 <0.001 Coronary Artery Disease 40164/491324 8.1% 1.9 0.001 Atrial Fibrillation 23829/237054 10% 1.15 <0.001 Ventricular Arrhythmia 8289/44294 18% 2.3 <0.001 Endocarditis 304/1664 18% 2.3 <0.01