The incidence and impact of sepsis in patients hospitalized with cholangiocarcinoma: Findings from the Nationwide Inpatient Sample.

Abstract

e16249 Background: Sepsis is a significant cause of morbidity and mortality in patients with cancer. This study examines the impact of sepsis on hospitalized patients with cholangiocarcinoma, focusing on its effect on mortality. By analyzing inpatient outcomes, this research aims to address a critical gap in the existing literature regarding the burden of sepsis in cholangiocarcinoma patients. Methods: Data from the 2019 National Inpatient Sample were analyzed to identify patients with a diagnosis of cholangiocarcinoma using International Classification of Diseases, 10th Revision (ICD-10) codes. The study population was divided into two groups: those admitted with sepsis and those without. Sociodemographic characteristics and comorbidities were systematically compared between the groups. The primary outcome was all-cause in-hospital mortality, with additional secondary outcomes evaluated. Multivariate regression models were used to identify differences in outcomes, with statistical significance defined as p < 0.05. Results: Among the 20,290 adult patients hospitalized with cholangiocarcinoma, 5,245 (25.85%) were diagnosed with sepsis at admission. Patients with sepsis were, on average, older (mean age: 68.8 years vs. 68.3 years) and included a higher proportion of males (57%) compared to females (43%). Cholangiocarcinoma patients with sepsis exhibited significantly increased odds of all-cause mortality (adjusted odds ratio [aOR]: 2.45; 95% confidence interval [CI]: 1.92–3.14; p > 0.0001), acute kidney injury (aOR: 2.40; 95% CI: 2.05–2.82; p < 0.001), and sudden cardiac death (aOR: 2.07; 95% CI: 1.10–3.90; p = 0.02). Additionally, these patients experienced longer hospital stays (mean length of stay: 6.9 days vs. 6.1 days) and incurred higher hospitalization costs ($89,620 vs. $70,844). Conclusions: Cholangiocarcinoma patients admitted with sepsis faced significantly greater risks of mortality, acute kidney injury, and sudden cardiac death, along with extended hospital stays and increased hospitalization costs compared to those without sepsis. These findings provide important insights into the poorer prognosis of cholangiocarcinoma patients with sepsis compared to those without this complication.