Abstract 6232: Pancreatic cancer epidemiology and impacts in patients admitted with sepsis: Insights from a nationwide inpatient sample

Abstract Background: Sepsis is a critical public health issue, contributing to high rates of hospitalization and mortality worldwide. While existing studies primarily focus on sepsis in patients with blood cancers or stem cell transplants, limited research addresses the impact of solid tumors, such as pancreatic cancer, on sepsis outcomes. This study examines the epidemiology and outcomes of sepsis in patients with pancreatic cancer, filling a crucial gap in the literature. Methods: Data from the National Inpatient Sample (NIS) spanning January 2019 to December 2021 was analyzed. Patients with a primary diagnosis of sepsis or severe sepsis were categorized based on the presence of pancreatic cancer. Key comparisons included demographic data, coexisting conditions, and clinical outcomes, with all-cause mortality as the primary endpoint. Secondary outcomes assessed complications, treatments, hospital length of stay, and costs. Statistical analyses employed multivariate regression models, with significance defined as p < 0.05. Results: The analysis included 7, 032, 966 adult sepsis admissions from January 1, 2019, to December 31, 2021, with 43, 779 (0.62%) also having pancreatic cancer. Patients with pancreatic cancer were older (average age 68.5 vs. 64.5 years, p < 0.001), predominantly male (56.9% vs. 43.1%, p < 0.001), and more frequently had a Charlson Comorbidity Index of 3 or higher (89.9% vs. 44.5%, p < 0.001). These patients exhibited a significantly higher risk of all-cause mortality, with an adjusted odds ratio (aOR) of 1.24, (95% CI 1.16 - 1.31). They also had increased odds of venous thromboembolism (aOR 2.65, 95% CI 2.27 - 3.10), gastrointestinal hemorrhage (aOR of 1.105, 95% CI 1.002 - 1.220) and disseminated intravascular coagulation (aOR of 1.19, 95% CI 1.01 - 1.40). However, renal replacement therapy, mechanical ventilation and vasopressors were used less frequently in pancreatic cancer patients (aOR 0.50, 95% CI 0.43-0.59), (aOR 0.78, 95% CI 0.70 - 0.87) and (aOR 0.51, 95% CI 0.46 - 0.56), respectively. Pancreatic cancer in sepsis patients was also associated with shorter hospital stays (6.66 days vs. 7.65 days) with an adjusted incidence rate ratio (aIRR) of 0.69, (95% CI 0.68 - 0.71) and lower hospitalization costs ($86, 649 vs. $98, 342, aIRR of 0.68, 95% CI 0.66 - 0.70). Conclusions: Sepsis patients with concurrent pancreatic cancer experienced significantly higher risks of mortality and other adverse outcomes, yet received less aggressive treatment, had shorter hospital stays, and incurred lower hospitalization costs. These findings may reflect a shift toward avoiding aggressive end-of-life care, as advocated by professional societies and governmental organizations. The results underscore the need for customized management strategies to minimize the impact of pancreatic cancer on outcomes for sepsis patients. Citation Format: Abdu Mohammed, Adamsegd I. Gebremedhen, Mamdouh Souleymane, Ibrahim Shanti, Jennifer Wiese, Stephen Roy, Toni O. Pacioles. Pancreatic cancer epidemiology and impacts in patients admitted with sepsis: Insights from a nationwide inpatient sample [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2025; Part 1 (Regular Abstracts); 2025 Apr 25-30; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2025;85(8_Suppl_1):Abstract nr 6232.