Clinical outcomes for low-income patients with early-onset colorectal cancer: An analysis of the National Inpatient Sample.

Abstract

e15697 Background: Despite recent global decreases in overall cancer incidence, the incidence of early-onset colorectal cancer (EOCRC) is steadily increasing in western populations. Limited data is available on the comorbid correlations for this unfortunately expanding population. We sought to examine the National Inpatient Sample (NIS) to describe in-hospital outcomes among low-income patients with EOCRC. Methods: Data were extracted from the NIS from the years 2019 and 2020. The NIS was searched for hospitalizations of adult patients with EOCRC, defined as all-cause colorectal cancer in patients 50 years old or younger. We then examined the outcomes of patients with the lowest incomes, or with a self-reported annual income of $50,000 or less. Propensity score matching was used to adjust for confounders and the primary outcome was inpatient mortality. SPSS software was used for statistical analysis and all values were powered to p < 0.001. Results: This study included 11,820 patients with EOCRC, of which 3,254 (27.5%) were identified as low income. Propensity score matching showed that low income patients with EOCRC had higher inpatient mortality (OR 1.488, CI 1.379-1.606, p < 0.001). On secondary analysis, low income EOCRC patients were more likely to have anemia (OR 1.457, CI 1.430-1.485), thrombocytopenia (OR 1.434, CI 1.367-1.504), hypertension (OR 1.676, CI 1.555-1.808), acute renal failure (OR 1.491, CI 1.436-1.547), pancreatitis (OR 1.394, CI 1.232-1.578), pericarditis (OR 1.471, CI 1.259-1.718), esophagitis (OR 1.423, CI 1.382-1.465), Crohn’s disease (OR 1.360, CI 1.230-1.504), severe liver disease (OR 1.407, CI 1.380-1.436), metastatic disease (OR 1.393, CI 1.374-1.412), secondary lymphomas (OR 1.488, CI 1.183-1.773), all-cause arrhythmias (OR 1.400, CI 1.301-1.506), all-cause shock (OR 1.477, CI 1.310-1.665), all-cause sepsis (OR 1.464, CI 1.421-1.509), all-cause coagulopathy (OR 1.364, CI 1.295-1.436), all-cause heart failure (OR 1.661, CI 1.508-1.828), all-cause stroke (OR 1.461, CI 1.345-1.586), and all-cause myocardial infarction (OR 1.596, CI 1.405-1.811). Conclusions: In this nationally representative, population‐based retrospective cohort study, low-income patients with EOCRC were associated with higher mortality and worse outcomes.