Racial disparities in major adverse cardiovascular and cerebrovascular events and healthcare resource utilization in patients with pancreatic cancer.

Abstract

e16466 Background: Pancreatic cancer is a lethal malignancy, and racial disparities in outcomes remain a major public health concern. Comorbidities such as cardiovascular and cerebrovascular events can significantly affect survival and quality of care. We utilized the National Inpatient Sample (NIS) from 2016–2021 to evaluate racial disparities in major adverse cardiovascular and cerebrovascular events (MACCE) and healthcare resource utilization in hospitalized pancreatic cancer patients. Methods: A retrospective cohort study was conducted using the NIS database to identify adult pancreatic cancer patients between 2016 and 2021. Demographic and clinical characteristics, including race, age, sex, socioeconomic factors, and comorbidities, were compared. Outcomes included mortality, myocardial infarction (MI), atrial fibrillation (A-fib), intracranial hemorrhage, and healthcare resource utilization metrics (length of stay [LOS] and total charges [TOTCHG]). Multivariable logistic regression models were employed to assess racial disparities in these outcomes, adjusted for potential confounders. Results: Among 622,379 pancreatic cancer patients, the racial distribution was White (73.3%), Black (14.3%), Hispanic (8.6%), Asian or Pacific Islander (3.5%), Native American (0.4%), and Other (3.1%). Black patients experienced significantly higher odds of mortality (OR 1.44, p < 0.001) and sudden cardiac arrest (OR 2.271, p < 0.001) compared to Whites. Similarly, Asian or Pacific Islander patients had elevated odds of mortality (OR 1.371, p < 0.001) and intracranial hemorrhage (OR 1.701, p = 0.008). Hispanic patients exhibited protective odds for MI (OR 0.839, p = 0.035) and acute congestive heart failure (OR 0.502, p = 0.044) compared to Whites. Across racial groups, atrial fibrillation was significantly less common in Black (OR 0.559, p < 0.001), Hispanic (OR 0.516, p < 0.001), and Asian or Pacific Islander (OR 0.567, p < 0.001) patients. Black and Other racial groups had significantly longer LOS compared to Whites (0.992 and 0.687 days, p < 0.001, respectively). Notably, Hispanic and Asian patients had significantly higher TOTCHG compared to Whites ($17,802.97 and $23,022.9, respectively, p < 0.001). Conclusions: This study reveals striking racial disparities in pancreatic cancer outcomes and associated MACCE, with Black and Asian patients experiencing worse outcomes, including higher mortality and increased rates of severe complications. In contrast, Hispanic patients demonstrated a lower risk for certain cardiovascular events. Disparities in LOS and healthcare charges further underscore inequities in care delivery. These findings emphasize the need for targeted interventions to address systemic healthcare inequities, optimize resource allocation, and improve outcomes for minority populations with pancreatic cancer.