Right-Sided vs Left-Sided Colorectal Cancer Hospitalization Outcomes in the US

OBJECTIVES: Colorectal cancer (CRC) is a major health concern, ranking third in incidence and second in mortality amongst cancers in the US. Right-sided (RS-CRC) comprises of ascending colon + 2/3 transverse while the Left Sided CRC (LS-CRC) comprises of 1/3 transverse, descending colon, sigmoid colon, and rectum have both morphological and treatment approaches. This study focuses on examining the differences in hospitalization characteristics and outcomes of RS-CRC vs LS-CRC.

METHODS: Data was extracted from 2020 HCUP National Inpatient Sample (NIS) based on ICD10 codes (RS-CRC = C180, C182, C183, C184) and (LS-CRC = C185, C186, C187, C20). Multivariate models were developed to explain LOS and total charges based on socio demographic, hospitalization characteristics and other Hospitalization outcomes.

RESULTS: A total of 8,480 RS-CC and 9,262 LS-CC hospitalizations were extracted. RS-CRC hospitalizations had average age = 70.24 years and equal gender distribution (F =51%), whereas LS-CRC hospitalizations were predominantly men (57.8%) with an average age 62.85 years. Most patients were White (68%) and Medicare was the primary payer for both RS-CRC (63%) and LS-CRC (44%). Private insurance was the next key Payer RS-CRC (23%) and LS-CRC (39%). RS-CRC and LS-CRC had similar Length of Stay (LOS) of 6.5 ± 6.02 days vs 6.4 ± 6.67 days. RS-CRC and LS-CRC have similar mortality outcomes (1.75% vs 1.55%). However, analysis of total charges revealed that LS-CRC had a higher total expenditure ($106,953.60 ± 102,610.7) compared to RS-CRC ($99,357.999 ± 5,856.56). Multivariate regression models to explain total charges showed significant impact of age, race, hospital characteristics, LOS and mortality for both RS-CRC and LS-CRC.

CONCLUSIONS: RS-CRC had similar LOS and mortality to LS-CRC, however LS-CRC had 7.5% more charges even though they differed in the age and payer distribution. Further research is needed to understand the impact of various procedures conducted during CRC hospitalization.