Metastatic prostate cancer and heart failure hospitalizations: An intersection.

Abstract

e17144 Background: Prostate cancer (PC) is the second most frequently diagnosed cancer in men. Those patients with metastatic prostate cancer(mPC) require cancer treatment for several months or years, which results in cardiac adverse effects, including heart failure (HF). We aim to identify the outcome of heart failure in mPC. Methods: We conducted a retrospective analysis utilizing the 2022 National Inpatient Sample (NIS) database. We analyzed hospitalizations from mPC with and without HF. We compared hospitalization characteristics and clinical outcomes employing T-tests and Chi-square tests. Results: In 2022, there were 16,996 hospitalizations of mPC, of which 2899 had associated HF. The mean age of mPC with HF was seen in older patients compared to those without HF (78 vs 74 years, p-value<0.001). In this cohort, racial distribution differed significantly between PC patients with and without HF (p < 0.001), with a higher proportion of White patients and a lower proportion of Hispanic patients observed in the HF group. The mortality rates of mPC patients with HF were 8.83% vs 6.60% in those without HF, with a p-value of <0.001. The multivariate logistic regression on the cohort showed an adjusted odds ratio of 1.36 ( 95% CI 1.28-1.48, p-value 0.002). A significant difference in insurance coverage was observed between groups (p < 0.001), with 85% of PC patients with HF insured through Medicare compared to 77% without HF. In comparison, those without HF had nearly twice the rate of private insurance coverage (15.4% vs. 8.8%). Disposition at discharge differed significantly between groups (p < 0.001); patients with HF were less frequently discharged home routinely (30.5% vs. 38.7%) and more often transferred to skilled nursing facilities (27.5% vs. 22.7%) compared to those without HF. The mean length of stay and total charge were significantly higher in mPC, averaging 7 days and $91034, compared to those without HF, who had an average of 6 days and $81851 (p-value<0.001). Conclusions: Our analysis revealed that mPC with HF had worse clinical outcomes and increased health care burden when compared to mPC hospitalizations without. This necessitates more aggressive treatment in patients with mPC with HF. Epidemiological characteristics of prostate cancer with and without heart failure. Variables Prostate Cancer with Heart Failure[2899](%) Prostate Cancer without Heart Failure[14097](%) p-Value Mean Age (Years) 78 74 <0.001 Mean LOS (Days) 7 6 0.002 Total Charges ($) 91,034 81,851 <0.001 Mortality (%) 8.83 6.60 <0.001 Race <0.001 White 68.76 66.08 African-American 20.79 20.12 Hispanics 6.11 8.69 Asian or Pacific Islander 2.26 2.33 Native American 0.32 0.39 Other 1.76 2.39 Insurance <0.001 Medicare 85.08 76.71 Medicaid 4.95 6.35 Private, including HMO 8.82 15.41 Self-pay 1.15 1.53 Region of the Hospital <0.001 Northeast 20.35 21.11 Midwest 28.04 22.69 South 30.56 35.68 West 21.04 20.52