Gender disparities in major adverse cardiovascular and cerebrovascular events among gastric cancer patients: A nationwide analysis (NIS 2016–2021).

Abstract

e16096 Background: Gastric cancer remains a leading cause of cancer mortality, with gender disparities in outcomes influenced by cardiovascular risk factors, resource utilization, and mortality rates. This study examines gender differences in MACCE, mortality, and healthcare costs among hospitalized gastric cancer patients using NIS data from 2016–2021. Methods: A retrospective cohort analysis was conducted using the NIS database to identify adult gastric cancer patients. Patients were stratified by gender, and demographic, clinical, and socioeconomic characteristics were compared. The primary outcomes included in-hospital mortality, myocardial infarction (MI), stroke, atrial fibrillation (A-fib), sudden cardiac arrest, and other MACCEs. Secondary outcomes included length of stay (LOS) and total hospital charges (TOTCHG). Multivariable logistic regression models adjusted for potential confounders were used to assess gender disparities in these outcomes. Results: Among 248,580 gastric cancer patients, 63.1% were male, & 36.9% were female. Males had a significantly higher prevalence of dyslipidemia (35.91% vs. 31.38%, p < 0.001), chronic obstructive pulmonary disease (16.54% vs. 15.25%, p = 0.0003), & atrial fibrillation (14.24% vs. 10.21%, p < 0.001), while females had a higher prevalence of obesity (9.38% vs. 7.17%, p < 0.001). Males had a lower risk of in-hospital mortality (OR 0.919, p = 0.019) & sudden cardiac arrest (OR 0.799, p = 0.015), but a higher risk of stroke (OR 1.296, p = 0.001) compared to females. Additionally, males had a lower likelihood of developing MI (OR 0.842, p = 0.009) and arrhythmias (OR 0.609, p < 0.001). Length of stay was similar between genders (p = 0.878). However, total hospital charges were significantly higher for males ($91,785.70 vs. $87,387.09, p < 0.001). Conclusions: This study reveals significant gender disparities in gastric cancer outcomes. Males had lower mortality and MI risk but higher stroke and atrial fibrillation risk. Despite similar LOS, males faced higher healthcare costs, emphasizing the need for gender-specific risk stratification and management. Outcome Odds Ratio 95% confidence P value Death 0.919 0.857 0.986 0.019 MI 0.842 0.74 0.958 0.009 Cerebral Artery Stenosis 0.876 0.69 1.111 0.276 Stroke 1.296 1.105 1.519 0.001 Sudden Cardiac 0.799 0.667 0.957 0.015 A Fib 0.619 0.582 0.659 <0.001 Arrhythmia 0.609 0.522 0.711 <0.001 ICH 0.82 0.608 1.107 0.196 Acute CHF 0.979 0.623 1.539 0.93 LOS 0.0112 -0.133 0.155 0.878 Total Health Charges -5296.334 -7620.04 -2972.62 <0.001