Obesity as a predictor of in-hospital outcomes in solid tumours with cardiovascular comorbidities.

Abstract

e24006 Background: Obesity is a risk factor for both cancer and cardiovascular (CVS) disease. Although its impact on the development of CVS conditions and mortality in cancer has been studied, the influence of obesity on prognosis of cancer patients (pts) with pre-existing CVS conditions remains unexamined. We aim to analyze the impact of obesity on in-hospital outcomes in solid tumor (ST) pts with pre-existing CVS conditions. Methods: National Inpatient Sample 2016-2020 was probed to identify all adult hospitalizations with primary diagnoses of various STs using ICD-10 codes. These cancers were grouped as follows: thoracic; pancreatic; gastrointestinal (GI)-colorectal, gastric, and esophageal; gynecological (GYN)-ovarian and breast; and genitourinary (GU)-renal cell carcinoma, bladder and prostate. Pts in each category with acute CVS conditions, such as myocardial infarction, stroke, and heart failure, were grouped. The cohort was categorized as obese (BMI >= 30) vs non-obese (BMI<30). Chi-square analyzed categorical variables, and multivariate regression analysis evaluated the impact of obesity on in-hospital outcomes of different STs with CVS conditions. Results: 1,829,587 ST pts with pre-existing CVS conditions were identified. ST pts with obesity were younger (mean age 67.57 vs 72.95 years) compared to non-obese. Among ST pts with obesity, 48% were female; 68% were White, 20% were African-American and 7% were Hispanics (all p<0.001). Among these pts, the prevalence of obesity was highest in GYN (20%), followed by thoracic (18%), GI (15%), GU (14%), and pancreatic (11%) cancers. Obese pts were found to have significantly lower odds of mortality but higher resource utilization such as length of stay (LOS) and total cost (TOTCHG) compared to non-obese pts across all cancers except pancreatic cancer, where the results were not significant (Table). Conclusions: Obesity is associated with improved mortality outcomes but worse resource utilization in hospitalized ST pts with CVS conditions, suggesting an intriguing obesity paradox. These findings highlight the complex interplay between obesity and outcomes in ST pts with CVS conditions, emphasizing the need for further research to inform management strategies and integrate cardio-oncology approaches. Obesity on outcomes of ST with CVS conditions. STs with CVS conditions [N] *Mortality[AOR**, 95% CI, p] *LOS[AOR**, 95% CI, p] *TOTCHG($)[B***, 95% CI, p] GYN [225,635] 0.62, 0.54-0.70, <0.001 1.62, 1.19-2.20, 0.002 3659, 878-6441, 0.010 Thoracic [757,014] 0.89, 0.86-0.92, <0.001 1.38, 1.28-1.49, <0.001 6718, 2333-11103, 0.003 GI [266,520] 0.59, 0.52-0.64, <0.001 1.53, 1.08-2.15, 0.016 14031, 9661-18400,<0.001 GU [483,654] 0.68, 0.60-0.76, <0.001 1.40, 1.11-1.77, 0.004 5308, 2709-7906, <0.001 Pancreas [96,764] 0.86, 0.71-1.05, 0.166 1.09, 0.65-1.84, 0.732 4557, (-)1481-10596, 0.139 *Ref: non-obese. **Adjusted Odds Ratio. ***Beta coefficient.