Racial disparities in major adverse cardiovascular and cerebrovascular events outcomes among gastric cancer patients.

Abstract

11070 Background: Racial disparities in healthcare outcomes represent a critical challenge in achieving equity in gastric cancer care. Gastric cancer, often associated with high morbidity and mortality, also places patients at risk for major adverse cardiovascular and cerebrovascular events (MACCE). This study explores racial disparities in MACCE outcomes among gastric cancer patients using data from the National Inpatient Sample (2016–2021), focusing on differences in mortality, myocardial infarction (MI), arrhythmias, and healthcare resource utilization. Methods: A retrospective cohort analysis of the NIS database from 2016 to 2021, identifying adult gastric cancer patients using ICD-10 codes. Demographic and clinical variables, including race/ethnicity, age, sex, income, and hospital characteristics, were analyzed. MACCE outcomes, including mortality, myocardial infarction (MI), atrial fibrillation (A-fib), arrhythmias, and other cardiovascular events, were compared across racial groups. Multivariable logistic regression adjusted for confounders to evaluate the odds of MACCE outcomes and healthcare utilization disparities. Results: Among 243,544 gastric cancer patients, the racial distribution included White (53.2%), Black (16.5%), Hispanic (17.3%), Asian or Pacific Islander (7.8%), Native American (0.7%), and Other (4.1%). Significant disparities were noted in MACCE outcomes: Black patients had higher odds of mortality (OR 1.196, p < 0.001) and sudden cardiac arrest (OR 2.206, p < 0.001) compared to Whites. Hispanic and Asian patients had significantly lower odds of myocardial infarction (OR 0.768, p = 0.011; OR 0.998, p = 0.991, respectively). Atrial fibrillation was significantly less frequent among Black (OR 0.486, p < 0.001), Hispanic (OR 0.4, p < 0.001), Asian (OR 0.466, p < 0.001), and Native American (OR 0.568, p = 0.009) populations compared to Whites. Notably, Hispanic and Asian or Pacific Islander patients had significantly higher total charges (TOTCHG) compared to Whites ($7,945.6 and $13,467.1 higher, respectively, p < 0.001). Length of stay (LOS) was significantly longer for Black patients (0.707 days, p < 0.001) compared to Whites. Conclusions: This study highlights significant racial disparities in MACCE outcomes, mortality, and healthcare resource utilization among gastric cancer patients. Black and Other racial groups demonstrated higher odds of mortality and sudden cardiac arrest, while Hispanic and Asian patients showed a protective effect against myocardial infarction and atrial fibrillation. Disparities in healthcare charges and LOS further emphasize systemic inequities. Addressing these disparities requires targeted interventions to reduce cardiovascular risks and improve healthcare access and equity for minority populations with gastric cancer.