Distress as a predictor of mortality risk: A cohort analysis.

449 Background: The Mortality Risk Machine Learning Model (MRM) is a tool designed to evaluate the likelihood of unfavorable outcomes in high-risk patients with metastatic cancer, enabling earlier initiation of advanced care planning. The US Oncology Network (The Network), practices use the National Comprehensive Cancer Network (NCCN) Distress Thermometer (DT) as a screening tool for health-related social needs (HRSNs). This dual approach ensures a more comprehensive understanding of a patient’s overall condition. With this study, we seek to understand the correlation between distress and mortality risk and to contribute to the broader discourse on the importance of addressing emotional health alongside physical health to improve the overall prognosis and quality of life for patients. Methods: Using distress data and mortality risk outcomes from July 2023 to May 2025 across 17 physician group practices in The Network, we evaluated the correlation between distress and mortality risk. A chi-squared test was conducted to determine the correlation between high distress (HD) and high mortality (HM). Results: Of 39,816 patients, 1% of total patients were in the High Distress and High Mortality group, 64% in Low Distress (LD) Low Mortality (LM) and 0.01% of the total population were in Very High Mortality (VHM) and Very High Distress (VHD) group as shown in Table 1. With risk ratio of 1.41 and confidence interval (95% CI= 1.31– 1.52), it was determined that HD patients face 41% higher mortality risk than patients with low distress. Conclusions: The study shows a positive relationship between high mortality risk and high distress. By adopting a comprehensive and holistic strategy that addresses the interconnected dimensions of distress, we can significantly reduce the burden on cancer patients, ultimately enhancing their overall well-being and quality of life. Future studies are required to understand the overall impact on total cost of care and outcomes. Distribution of patients by distress and mortality risk. Mortality Risk Very High High Moderate Low Total Distress Risk Very high 67 (0%) 78 (0%) 65 (0%) 544 (1%) 754 High 208 (1%) 272 (1%) 253 (1%) 2,130(5%) 2,863 Moderate 315 (1%) 492 (1%) 372 (1%) 4,259 (11%) 5,438 Low 1,465 (4%) 2,166(5%) 1,743 (4%) 25,387 (64%) 30,761 Total 2,055 3,008 2,433 32,320 39,816