Disparities in outcomes of esophageal cancer hospitalizations: A trend analysis (2008-2021).

e16156 Background: Esophageal cancer has a poor prognosis with a 21.6% five-year relative survival and demographic variations have been reported with esophageal cancer. This study aims to identify trends in demographic-specific disparities in mortality among esophageal cancer admissions. Methods: This is a retrospective longitudinal trends study using the Nationwide Inpatient Sample (NIS) database (2008-2021). We identified hospitalizations with esophageal cancer using ICD-9 and ICD-10 codes. The study highlights disparities in mortality outcomes stratified by age, gender and race categories. Results: There were 527,128 hospitalizations of esophageal cancer patients between 2008 and 2021. Over the period, the mean age at hospitalization increased from 66 years to 67 years (P < 0.001). Majority of the admissions were elderly patients (≥65 years) and Caucasians (P < 0.001). Most patients had Medicare and were in large and urban teaching hospitals (P < 0.001). The overall inpatient mortality rate declined from 10.2% in 2008 to 8.7% in 2019, followed by an increase to 9.2% in 2021 (P trend = 0.018). While the young adult population (< 45 years) showed a trend towards rising mortality, it was not statistically significant (P trend = 0.17). Significant reductions in mortality were observed only in patients aged ≥65 years (P trend = 0.004). In the gender subgroup analysis, males experienced a notable decline in mortality (P trend = 0.014). Among racial groups, only Caucasians showed a significant improvement in mortality trends (P trend = 0.006) over the study period. Conclusions: Inpatient mortality among esophageal cancer admissions has improved overall; however, significant demographic-related disparities were identified. Coordinated efforts to reduce these disparities will be essential in attaining sustained improvements in outcomes for esophageal cancer. Disparities in outcomes of esophageal cancer hospitalizations: A trend study (2008-2021). Mortality rate, % 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 P- Trend value Overall 10.19 9.55 9.05 9.16 9.46 9.22 8.94 9.05 8.97 8.94 8.68 8.66 9.15 9.19 0.02 Young (<45 years) 7.37 5.87 5.98 11.43 8.76 6.1 10.16 5.34 7.22 9.62 10.14 8.96 9.68 8.1 0.17 Middle-aged (45- 64 years) 10.02 8.01 8.77 8.83 8.8 8.42 8.38 8.66 8.54 8.73 7.99 8.13 8.77 9.03 0.48 Elderly (>65 years) 10.48 10.89 9.46 9.28 10 9.97 9.28 9.51 9.34 9.05 9.06 8.99 9.36 9.32 0.004 Females 8.09 8.41 8.34 9.28 9.17 7.93 8.16 7.52 7.83 8.76 7.96 7.83