Trends in inpatient outcomes of bladder cancer: 2008-2021.

Abstract

674 Background: Bladder cancer is a common malignancy of the urinary tract that is associated with about 16,840 estimated deaths in 2024. With the recent advances in bladder cancer treatment, it is unknown whether the trends in hospitalization outcomes have changed over time. We evaluated the trends in hospitalization outcomes among patients with a diagnosis of bladder cancer. Methods: This is a retrospective longitudinal trends study using the Nationwide Inpatient Sample (NIS) database (2008-2021). We identified hospitalizations with bladder cancer using ICD-9 and ICD-10 codes. Multivariate logistic and linear regression models were used to examine the trends in mortality outcomes stratified by demographic subgroups (age, gender and race). Results: There were over a million (1,123,567) hospitalizations with bladder cancer between 2008 and 2019. 73.5% were males; The mean age of the patients was 73.5 years. There was an overall increase in mortality amidst admissions with bladder cancer, from 4.5% in 2008 to 4.9% in 2021 (adjusted odds ratio [aOR]: 1.01; P-trend = 0.010). In the age subgroup, elderly patients (≥65 years) had an increase in mortality (aOR: 1.007; P-trend = 0.028). The young adults (18 - 44 years) and middle-aged adults (45 - 64 years) had no significant change in mortality rate (P-trend = 0.31 and P-trend = 0.131 respectively). For gender subgroup analysis, worse mortality outcomes were seen for males (aOR:1.01; P-trend=0.001); females had similar mortality over the period (P-trend=0.53). Racial subgroup analysis showed increased mortality outcomes for non-Hispanic White patients (aOR:1.01; P-trend=0.03). Black (P-trend=0.77) and Hispanic (P-trend=0.46) patients had no significant change in mortality outcomes. Conclusions: There was an overall increase in hospital mortality outcomes for bladder cancer patients from 2008-2021. While treatment advances continue to show improvement in survival outcomes, efforts are needed to ensure that hospitalized patients with bladder cancer have improved mortality outcomes. Inpatient mortality trends of bladder cancer stratified by demographic subgroups. Adjusted Odds Ratio P-Trend 95% Confidence Interval Overall Mortality 1.01 0.010 1.002-1.014 Young adults (18 - 44 years) 1.03 0.31 0.971-1.099 Middle-aged adults (45 - 64 years) 1.01 0.131 0.997-1.024 Elderly patients (≥65 years) 1.01 0.028 1.001-1.014 Male 1.01 0.001 1.005-1.019 Female 1.0 0.53 0.986-1.007 Non-Hispanic White 1.01 0.03 1.001-1.015 Black 1.00 0.77 0.979-1.016 Hispanic 0.99 0.46 0.968-1.015