Economic and clinical impact of influenza virus infection in hospitalized lung cancer patients: A National Inpatient Sample analysis.

Abstract

e20086 Background: Lung cancer is a leading cause of cancer-related mortality, with patients often susceptible to complications from infections, including influenza. Understanding the clinical and economic impact of influenza in hospitalized lung cancer patients is essential for optimizing care and resource allocation. This study assessed the effect of influenza infection on healthcare resource utilization and in-hospital outcomes. Methods: Using the National Inpatient Sample (NIS) database from 2016 to 2021, we identified hospitalized patients with a principal diagnosis of lung cancer based on relevant ICD-10 codes. Patients were stratified into two groups based on the presence or absence of influenza infection. The primary outcome was resource utilization, assessed through length of stay (LOS) and total hospital charges (THC). Secondary outcomes included in-hospital mortality, need for mechanical ventilation (MV), co-occurrence of pneumonia (PNA) or acute respiratory distress syndrome (ARDS), and disposition to specialized centers upon discharge (non-routine home discharge). We evaluated the baseline characteristics using the t-test and chi-square test. Multivariable regression analyses, adjusting for patient and hospital characteristics, were performed to assess the impact of influenza infection on these outcomes. Results: A total of 84,196 patients with lung cancer were included in the study, of whom 126 (0.15%) had an associated influenza infection. Multivariable analysis revealed that patients with influenza had a significantly longer LOS, with an increase of 2.89 days (95% confidence interval [CI] 0.35–5.44; P<0.03). However, there was no statistically significant difference in adjusted THC. Additionally, patients with influenza had higher odds of requiring MV (adjusted odds ratio [aOR] 2.26, 95% CI 1.06–4.80; P=0.03). No statistically significant differences were observed in mortality, association with pneumonia or ARDS, or non-routine discharge disposition. Conclusions: Our study revealed that influenza infection in lung cancer patients is associated with increased morbidity, reflected in prolonged hospital stays and higher ventilation needs, without significant differences in mortality. Preventive measures, such as vaccination, may mitigate these impacts, improving outcomes and reducing healthcare burden in this vulnerable population.