The prevalence and outcomes of hypercalcemia in Black American patients hospitalized with lung cancer: Findings from the Nationwide Inpatient Sample.

Abstract

e20537 Background: Hypercalcemia is a common complication in cancer patients, often associated with significant morbidity. African American lung cancer patients are at increased risk of developing hypercalcemia due to mechanisms such as bone metastasis or the secretion of parathyroid hormone-related peptide (PTHrP), as seen in cases like squamous cell carcinoma of the lung. However, the specific impact of hypercalcemia on clinical outcomes in African American lung cancer patients remains underexplored. This study investigates the effects of hypercalcemia on inpatient outcomes in this population, addressing a critical gap in the existing literature. Methods: Using the 2019 National Inpatient Sample, we identified African American patients diagnosed with lung cancer based on International Classification of Diseases, 10th Revision (ICD-10) codes. The cohort was stratified into two groups: those with hypercalcemia and those without. Sociodemographic characteristics and comorbidities were compared between the groups. The primary outcome assessed was all-cause mortality, with additional secondary outcomes also evaluated. Multivariate regression models were employed to analyze disparities in outcomes between the groups, with statistical significance defined as p < 0.05. Results: Among 41,500 adult African American patients hospitalized with lung cancer, 1,899 (4.57%) were diagnosed with hypercalcemia. These patients were older on average (mean age 69.9 vs. 67.1 years, p < 0.001) and had a higher proportion of males (55% vs. 45%, p < 0.001). Hypercalcemia was associated with higher odds of all-cause mortality (adjusted odds ratio [aOR], 1.48; 95% confidence interval [CI], 1.07–2.05; p < 0.005) and acute kidney injury (aOR, 1.54; 95% CI, 1.20–2.31; p < 0.001). Patients with hypercalcemia also experienced longer hospital stays (mean length of stay, 8.3 days vs. 6.5 days; p < 0.001) and incurred higher hospitalization costs ($90,728 vs. $74,285; p < 0.001). However, there were no significant differences in the risk of pulmonary embolism, sepsis, or disseminated intravascular coagulation between African American lung cancer patients with and without hypercalcemia. Conclusions: African American lung cancer patients with concurrent hypercalcemia had significantly higher odds of mortality and acute kidney injury, as well as longer hospital stays and higher hospitalization costs, compared to those without hypercalcemia. These findings underscore the importance of targeted management strategies in this population. strategies to reduce the negative impact of hypercalcemia on outcomes in lung cancer patients.