The prevalence and outcomes of ascites in patients hospitalized with pancreatic cancer: Insights from the Nationwide Inpatient Sample.

Abstract

e16411 Background: Ascites is a frequent complication in cancer patients, significantly contributing to morbidity. Pancreatic cancer patients, particularly those with metastatic disease, are at an increased risk of developing ascites. Despite its clinical importance, the impact of ascites on hospitalization outcomes in pancreatic cancer patients remains inadequately studied. This research aims to investigate the effects of ascites on inpatient outcomes in this population, addressing a notable gap in the current body of knowledge. Methods: The 2019 National Inpatient Sample was analyzed to identify patients with a diagnosis of pancreatic cancer using International Classification of Diseases, 10th Revision (ICD-10) codes. The study cohort was divided into two groups: patients admitted with ascites and those without ascites. Sociodemographic characteristics and comorbidities were systematically compared between the groups. The primary outcome was all-cause in-hospital mortality, while additional secondary outcomes were also evaluated. Multivariate regression models were used to examine differences in outcomes between the groups, with statistical significance defined as p < 0.05. Results: Among 93,330 adult patients hospitalized with pancreatic cancer, 15,180 (16.2%) had concurrent ascites. These patients were significantly younger, with a mean age of 66.1 years compared to 69.0 years in those without ascites (p < 0.005), and included a higher proportion of males (56%) compared to females (44%). Patients with pancreatic cancer and concurrent ascites exhibited significantly increased odds of all-cause mortality (adjusted odds ratio [aOR] 2.30, 95% confidence interval [CI] 2.02–2.62, p < 0.001), concurrent gastrointestinal hemorrhage (aOR 1.25, 95% CI 1.04–1.51, p = 0.019), acute kidney injury (aOR 1.86, 95% CI 1.68–2.05, p < 0.001), and septic shock (aOR 1.77, 95% CI 1.52–2.05, p < 0.001). Additionally, these patients experienced longer hospital stays (mean length of stay: 7.4 days vs. 5.6 days; p < 0.005) and higher hospitalization costs ($81,420 vs. $63,100; p < 0.001). Conclusions: Pancreatic cancer patients with concurrent ascites had substantially higher odds of mortality, acute kidney injury, gastrointestinal hemorrhage, and septic shock. They also experienced longer hospital stays and incurred greater hospitalization costs compared to patients without ascites. These findings provide important insights into the prognosis of pancreatic cancer patients with ascites and highlight the need for targeted management strategies for this high-risk population.