RISK FACTOR AND PREDICTION OF IN-HOSPITAL MORTALITY FOLLOWING COLORECTAL CANCER SURGERY: A NATIONAL INPATIENT SAMPLE STUDY
Author(s)
YEBIN YOON, PharmD1, Chanhyun Park, MEd, RPh, PhD2, Sun-Kyeong Park, PhD1.
1The Catholic University of Korea, Bucheon, Korea, Republic of, 2The University of Texas at Austin, Austin, TX, USA.
1The Catholic University of Korea, Bucheon, Korea, Republic of, 2The University of Texas at Austin, Austin, TX, USA.
OBJECTIVES: In-hospital mortality following colorectal cancer surgery remains an important perioperative outcome, highlighting the need for risk stratification using routinely available clinical information. This study aimed to identify patient-level and surgical factors associated with in-hospital mortality and develop a nomogram for mortality risk prediction during the index hospitalization.
METHODS: This retrospective observational study used the Healthcare Cost and Utilization Project National Inpatient Sample from 2015 Q4 to 2021. Adult hospitalizations were included if patients aged ≥18 years had both an ICD-10-CM diagnosis code for colorectal cancer and an ICD-10-PCS procedure code for colorectal surgery during the same hospitalization, defined as the index hospitalization. The primary outcome was in-hospital mortality. Candidate predictors included demographics, admission type, surgical factors, and major comorbidities. Survey-weighted multivariable logistic regression identified independent mortality-associated factors. Significant predictors were incorporated into a nomogram, and discrimination was assessed using the C-index.
RESULTS: A weighted total of 133,046 hospitalizations were analyzed. The mean age was 66.1 years, and the in-hospital mortality rate was 1.76%. Compared with patients aged 18-49 years, those aged ≥80 years had higher odds of in-hospital mortality (OR 2.94, 95% CI 2.25-3.83). Non-elective admission versus elective admission (OR 3.36, 95% CI 2.95-3.82), VD (OR 6.40, 95% CI 5.73-7.15), VTE (OR 2.61, 95% CI 2.09-3.25), HF (OR 1.92, 95% CI 1.73-2.12), severe renal failure (OR 1.50, 95% CI 1.21-1.86), and COPD (OR 1.18, 95% CI 1.05-1.32) were independently associated with mortality. The nomogram showed good discrimination (C-index = 0.875).
CONCLUSIONS: Routinely available patient-level and surgical factors identified colorectal cancer surgical hospitalizations at increased risk of in-hospital mortality. A nomogram incorporating these factors may support perioperative risk stratification, pending external validation.
METHODS: This retrospective observational study used the Healthcare Cost and Utilization Project National Inpatient Sample from 2015 Q4 to 2021. Adult hospitalizations were included if patients aged ≥18 years had both an ICD-10-CM diagnosis code for colorectal cancer and an ICD-10-PCS procedure code for colorectal surgery during the same hospitalization, defined as the index hospitalization. The primary outcome was in-hospital mortality. Candidate predictors included demographics, admission type, surgical factors, and major comorbidities. Survey-weighted multivariable logistic regression identified independent mortality-associated factors. Significant predictors were incorporated into a nomogram, and discrimination was assessed using the C-index.
RESULTS: A weighted total of 133,046 hospitalizations were analyzed. The mean age was 66.1 years, and the in-hospital mortality rate was 1.76%. Compared with patients aged 18-49 years, those aged ≥80 years had higher odds of in-hospital mortality (OR 2.94, 95% CI 2.25-3.83). Non-elective admission versus elective admission (OR 3.36, 95% CI 2.95-3.82), VD (OR 6.40, 95% CI 5.73-7.15), VTE (OR 2.61, 95% CI 2.09-3.25), HF (OR 1.92, 95% CI 1.73-2.12), severe renal failure (OR 1.50, 95% CI 1.21-1.86), and COPD (OR 1.18, 95% CI 1.05-1.32) were independently associated with mortality. The nomogram showed good discrimination (C-index = 0.875).
CONCLUSIONS: Routinely available patient-level and surgical factors identified colorectal cancer surgical hospitalizations at increased risk of in-hospital mortality. A nomogram incorporating these factors may support perioperative risk stratification, pending external validation.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EPH187
Topic
Clinical Outcomes, Epidemiology & Public Health
Disease
Cardiovascular Disorders (including MI, Stroke, Circulatory), Diabetes/Endocrine/Metabolic Disorders (including obesity), Oncology