Hospitalized oncology patients with diarrhea: Clinical outcomes and prognostic factors.

Abstract

11136 Background: Diarrhea is a frequent cause of hospitalization in oncology patients and may lead to substantial morbidity and mortality. However, data on short-term outcomes and prognostic factors in hospitalized cancer patients with diarrhea are limited. This study aimed to evaluate clinical outcomes and identify factors associated with poor prognosis in this population. Methods: Medical records of 6,349 oncology patients hospitalized over a 3-year period were retrospectively reviewed. A total of 163 adult patients hospitalized primarily for diarrhea were included; patients with immune checkpoint inhibitor–related diarrhea were excluded. Collected variables included demographic characteristics, disease stage, Eastern Cooperative Oncology Group (ECOG) performance status, febrile neutropenia at admission, systemic anticancer therapy, serum albumin level, and diarrhea grade. Primary outcomes were intensive care unit (ICU) admission and 30-day mortality. Logistic regression analysis was used to identify independent predictors of mortality. Results: Diarrhea accounted for 2.6% of all oncology-related hospitalizations, and 83.4% of patients had grade ≥3 diarrhea. ICU admission was more frequent in patients with ECOG ≥2 compared with those with ECOG < 2 (42.4% vs 14.4%, p < 0.001) and in patients with grade ≥3 diarrhea (27.9% vs 7.4%, p = 0.024). The overall 30-day mortality rate was 16.0% and was higher in patients with ECOG ≥2 (39.0% vs 2.9%, p < 0.001), metastatic disease (23.5% vs 7.7%, p = 0.006), and grade ≥3 diarrhea (19.1% vs 0%, p = 0.009). Febrile neutropenia was not associated with ICU admission or mortality. In multivariable analysis, ECOG ≥2 (OR: 17.1, p < 0.001) and lower serum albumin level (OR: 0.42, p = 0.049) were independent predictors of 30-day mortality. Diarrhea grade was excluded from the multivariable model due to complete separation. Conclusions: Diarrhea in hospitalized oncology patients is associated with substantial ICU utilization and short-term mortality, independent of febrile neutropenia. Poor functional status and low serum albumin are key prognostic factors, highlighting that diarrhea should be regarded as a potentially life-threatening condition requiring early risk stratification and prompt supportive care.