Epidemiology and outcomes of aspiration pneumonia in White American patients hospitalized with nasopharyngeal cancer: A nationwide analysis.

Abstract

e18104 Background: Nasopharyngeal cancer (NPC) is commonly linked to dysphagia, which can result from tumor invasion or treatment-related side effects, such as radiation therapy. Dysphagia significantly elevates the risk of aspiration pneumonia (AP), a prevalent complication in this population. Despite the known association between AP and NPC, its epidemiology and clinical impact among White American patients with NPC remain understudied. This study aims to quantify the burden of AP in NPC-related hospitalizations and evaluate its effect on inpatient outcomes, addressing a key gap in the oncological and infectious disease literature. Methods: White American patients hospitalized with nasopharyngeal cancer (NPC) in 2019 were identified using International Classification of Diseases, 10th Revision (ICD-10) codes. The cohort was divided into two groups based on the presence or absence of aspiration pneumonia (AP). The primary outcome was all-cause in-hospital mortality, multiple secondary outcomes utilization, length of stay (LOS), and hospitalization costs were also evaluated. Multivariate regression models were employed to examine disparities between the groups, with statistical significance defined as p < 0.05. Results: Among 13,850 White American patients hospitalized with nasopharyngeal cancer (NPC), 2,274 (16.4%) were diagnosed with aspiration pneumonia (AP). Patients with AP were significantly older, with a mean age of 67.2 years compared to 65.1 years in those without AP (p < 0.005), and a larger proportion were male (78%) compared to female (22%). NPC patients with AP had markedly higher odds of in-hospital mortality (adjusted odds ratio [aOR] 2.42; 95% CI, 1.70–3.45; p < 0.001), respiratory failure (aOR 3.75; 95% CI, 3.01–4.66), and mechanical ventilation use (aOR 1.76; 95% CI, 1.25–2.48; p < 0.001). However, no statistically significant differences were observed in the odds of disseminated intravascular coagulation or pulmonary embolism. Hospitalizations involving AP were associated with significantly prolonged LOS (9.1 vs. 6.5 days, P<0.001) and higher total costs ($109848 vs. $75225, P<0.001). Conclusions: Hospitalizations of nasopharyngeal cancer (NPC) patients complicated by aspiration pneumonia (AP) are linked to significantly higher risks of in-hospital mortality, respiratory failure, extended length of stay (LOS), and increased healthcare costs. These findings highlight the urgent need for targeted interventions to reduce AP-related morbidity and mortality in this vulnerable patient population. Future research should prioritize developing and implementing preventive and therapeutic strategies to enhance clinical outcomes for this high-risk group.