Racial and gender disparities in the prevalence of severe ARDS among lung cancer patients.

Abstract

e23088 Background: Acute Respiratory Distress Syndrome (ARDS) is a critical challenge in managing severely ill patients, especially those with lung cancer, the leading cause of cancer-related mortality worldwide. Lung cancer increases ARDS risk through pulmonary complications and treatment toxicities. While disparities in severe ARDS requiring mechanical ventilation are documented, data on race and gender influences in lung cancer patients remain limited. Methods: This retrospective study identified mechanically ventilated ARDS patients from the 2018–2020 National Inpatient Sample (NIS) and Healthcare Cost and Utilization Project (HCUP) using ICD-10 codes. Patients were grouped by lung cancer status, with analyses focusing on sex and racial distributions. Mean age differences were assessed using a weighted Student’s t-test, and categorical variables were analyzed with the Rao-Scott modified chi-square test. National estimates were calculated using NIS sampling design elements to ensure representativeness. Statistical significance was set at p < 0.05, and all analyses were conducted in SAS 9.4. Results: Among ARDS patients without lung cancer (N = 17,405), racial distribution was White 54.9%, Black 15.5%, Hispanic 16.1%, Asian/Pacific Islander 3.6%, Native American 2.1%, and Other 7.8%. In ARDS patients with lung cancer (N = 265), the distribution shifted to White 67.9%, Black 11.3%, Hispanic 3.8%, Asian/Pacific Islander 9.4%, Native American 2.2%, and Other 5.3%. Gender disparities were also notable, with females comprising 54.7% of lung cancer ARDS cases compared to 45.3% of males (p < 0.001). Black, Hispanic, and Native American patients were underrepresented in the lung cancer ARDS cohort, suggesting disparities in access to care, disease progression, or diagnosis. Conclusions: This study highlights racial and gender disparities in ARDS among lung cancer patients, with White and female patients overrepresented, while Black, Hispanic, and Native American populations are underrepresented. These disparities may stem from inequities in care, disease recognition, or biological factors. Addressing these gaps requires targeted research, early detection, and equitable access to critical care to improve outcomes for all ARDS patients. Racial and gender disparities in the prevalence of severe ARDS among lung cancer patients comparison table. Patients with ARDS on mechanical ventilation without lung cancer (N=17405) Patients with ARDS on mechanical ventilation with lung cancer (N=265) P values Mean SE Mean SE Age (years) 57.11 0.28 67.42 1.39 <0.0001 N (weighted) % N (weighted) % Sex <0.0001  Male 9760 56.1 120 45.3  Female 7640 43.9 145 54.7 Race <0.0001  White 9560 54.9 180 67.9  Black 2695 15.5 30 11.3  Hispanic 2805 16.1 10 3.8  Asian or Pacific Island 620 3.6 25 9.4  Native American 360 2.1 6 2.2  Other 1365 7.8 14 5.3