OBJECTIVES : A higher risk of death resulting from congestive heart failure (CHF) has been observed among patients with endometrial cancer compared to the general population. Shared risk factors and use of antineoplastic treatments can potentiate the risk of CHF-caused death in patients with endometrial cancer. The objective of this study is to evaluate the association of CHF with hospital outcomes among patients with endometrial cancer in the U.S.

METHODS : A retrospective study was conducted using the 2015-2017 National Inpatient Sample. The study population involved hospitalized women with endometrial cancer. The primary independent variable was the presence of CHF. The dependent variables were in-hospital mortality, length of hospitalization stay (LOS), and hospital costs per hospitalization. Logistic regression, negative binomial regression, and general linear model (log link and gamma distribution) were used to examine the associations between these variables, controlling for individual and hospital level covariates.

RESULTS : Out of the 8,464 hospitalized patients with endometrial cancer, 441 had comorbid-CHF (5.2%). The predicted in-hospital mortality was higher in endometrial cancer patients with CHF [4.74% (1.95%-7.53%)] than those without CHF [3.11% (2.07%-4.15%)], although statistical significance was not found (OR=1.58; 95% CI=0.79-3.17; p=0.200). Endometrial cancer patients with CHF were 1.55 times more likely to have a higher average LOS [6.97 days (6.22-7.73 days)] than those without CHF [4.50 days (4.23-4.77 days) (IRR=1.55; 95% CI=1.41-1.71; p<0.001)]. The predicted average hospital costs were 32% higher in endometrial cancer patients with CHF [$15,864 ($14,384-$17,343)] than those without CHF [$12,061 ($11,438-$12,658) (Cost Ratio=1.32; 95% CI=1.21-1.43; p<0.001)].

CONCLUSIONS : The presence of CHF was found to increase the LOS and hospital costs in patients with endometrial cancer. Identification of risk factors contributing to the observed outcomes may provide personalized interventions for patients that improve long-term health and lower economic strains.