Epidemiology and outcomes of sepsis in patients hospitalized with esophageal cancer: A nationwide analysis.

Abstract

e16068 Background: Esophageal cancer (EC) originates in the lining of the esophagus and often necessitates hospitalization in advanced stages. Sepsis, a severe and potentially fatal complication, poses significant challenges for hospitalized patients with EC. This study investigates and compares the outcomes of EC hospitalizations complicated by sepsis to enhance understanding and improve patient care strategies. Methods: Hospitalizations with a diagnosis of esophageal cancer were identified from the 2019 National Inpatient Sample (NIS) using ICD-10 codes. Patients were categorized based on the presence or absence of sepsis. Sociodemographic characteristics and comorbidities were analyzed. The primary outcome was in-hospital all-cause mortality, while secondary outcomes included complication rates. Multivariable regression analyses were performed to assess associations, with statistical significance defined as p < 0.05. Results: Among the 34,030 hospitalizations for esophageal cancer, 4,190 (12.3%) involved sepsis. Patients in the sepsis group were older, with a mean age of 68.1 years compared to 67.3 years in those without sepsis (p < 0.05). Sepsis was also associated with a significantly higher risk of in-hospital mortality (adjusted odds ratio [aOR] 2.74; 95% CI: 2.22–3.38, p < 0.001). Additionally, patients with sepsis had significantly higher odds of developing respiratory failure ([aOR] 4.21; 95% CI: 3.57–4.97, p < 0.001), requiring mechanical ventilation (aOR 2.64; 95% CI: 1.95–3.58, p < 0.001), and experiencing pulmonary embolism (aOR 1.59; 95% CI: 1.06–2.38, p < 0.001). Patients with sepsis also exhibited significantly higher odds of acute kidney injury (aOR 2.80; 95% CI: 2.35–3.33, p < 0.001) and deep venous thrombosis (aOR 2.94; 95% CI: 1.74–4.98). However, there were no statistically significant differences in the odds of gastrointestinal hemorrhage. Conclusions: Hospitalizations for esophageal cancer complicated by sepsis are strongly linked to increased in-hospital mortality and severe complications. These findings highlight the urgent need for tailored interventions to reduce the morbidity and mortality associated with sepsis in this high-risk population. Future research should prioritize refining preventive measures and therapeutic strategies to enhance clinical outcomes for oncology patients facing these challenges.