Disparities in cachexia and anorexia in hospitalized female patients with breast cancer: A national population-based study.

Abstract

12097 Background: Breast cancer is the most common cancer in females in the US. Cachexia and anorexia are common complications from either the disease itself or the treatment regimen. Specific disparities in the prevalence of anorexia and cachexia in female breast cancer patients is not known. This study seeks to address this gap in knowledge by comparing the prevalence of this issue among different demographic factors. Methods: The National Inpatient Sample (NIS) databases (2016–2021) of the Healthcare Cost and Utilization Project (HCUP) was used. We applied discharge weight (DISCWT) provided in the database to generate the national estimates. Pearson Chi-square test for categorical variables and Student’s t-tests/one-way ANOVA for continuous variables were applied to compare the baseline demographics and hospital characteristics between the groups. The objective of the study was to determine demographic factors associated with increased cachexia, specifically race (African American vs all races), income (lowest quarterlies vs highest), Insurance type (private vs all types) and age (older than 65 years old vs younger). Multivariate linear and logistic regression models were used to adjust for confounders such as demographics, tobacco use, hypertension, COPD, Ischemic heart disease, prior CVA, and prior diagnosis of anorexia nervosa. Results: Anorexia, cachexia or malnutrition were documented in 12% of 1,037,185 hospitalizations of females with breast cancer. After adjusting for confounders, there were higher odds of anorexia and cachexia in patients of the African American race (aOR:1.28; CI 1.11 - 1.52; p-value < 0.001) and patients who are 65 years old or older (aOR:1.18; CI 1.06 - 1.35; p-value 0.015). Having a private insurance was associated with lower odds of anorexia and cachexia (aOR:0.69; CI 0.62 - 0.78; p-value < 0.001). There were no significant differences between patients of different levels of income. Conclusions: Female breast cancer patients of certain demographics have higher odds of developing cachexia or anorexia, a very common complication of breast cancer. Further considerations for these vulnerable populations should be studied and focused efforts should be made to ensure adequate healthcare access for all demographics. Demographic studied Prevalence of anorexia/cachexia (aOR, P-value, CI) African American race vs all races 1.28, <0.001*, 1.11 - 1.52 Age ≥ 65 vs <65 1.18, 0.015*, 1.06 - 1. 35 Private insurance vs all insurance types 0.69, <0.001*, 0.62 - 0.78 Income (lowest quarterile vs highest) 1.05, 0.45, 0.81 - 1.23 *Statistically significant.