Disparities in VTE occurrences among hospitalized patients with cancer in teaching vs non-teaching hospitals: A National Inpatient Sample study.

249 Background: Venous thrombo-embolism (VTE) is not only a complication but also a known cause of morbidity and mortality in hospitalized cancer patients. Our study aims to compare the prevalence and socio-demographic factors associated with in-hospital VTE among cancer discharges from U.S. teaching versus non-teaching hospitals. Methods: We performed a retrospective cross-sectional study using the National Inpatient Sample from 2018-2021. Adult (≥18 y) cancer discharges and VTE diagnosis were identified with ICD-10-CM codes. We used survey design variables (discharge weights, hospital primary sampling units, and year-specific strata) to produce nationally representative estimates and calculated weighted VTE prevalence by teaching status (TH). We utilized a multivariable survey-weighted logistic regression to assess the association between TH and VTE, adjusting for various factors. Results: We analyzed 2146143 cancer discharges with a weighted N = 10 730 712 from 17,260 hospitals in 809 strata. VTE occurred in 5.25 % of teaching-hospital discharges versus 4.13 % of non-teaching discharges (absolute difference 1.12 percentage points; p < 0.001). Cancer discharges from teaching hospitals had 25 % higher adjusted odds of in-hospital VTE than those from non-teaching hospitals (adjusted odds ratio [aOR] 1.25, 95 % CI 1.22–1.28; p < 0.001). Compared with 2018, VTE odds were unchanged in 2019, modestly higher in 2020 (aOR 1.03, 95 % CI 1.00–1.07; p = 0.034), and increased further in 2021 (aOR 1.08, 95 % CI 1.05–1.12; p < 0.001). Female sex (aOR 1.09 p<.001), Black race (aOR1.33 p<.001), Medicaid (aOR 1.12 p<.001), private insurance (aOR 1.13 p<.01), self-pay (aOR 1.16 p<.001), and high comorbidity index (CCI ≥ 5, aOR 1.16 p<.001) were additional independent predictors. Asian/Pacific-Islander race (aOR 0.80) and residence in the South (aOR 0.96 p<.01) were associated with lower odds. Conclusions: Teaching hospitals have a 25 % higher adjusted risk and an increased prevalence of in-hospital VTE among cancer patients. Disparities by race, payer, and geography persist despite adjustment. Enhanced thromboprophylaxis protocols and equity-focused quality-improvement initiatives in teaching centers may mitigate preventable VTE events in this high-risk population. Predictor Adjusted OR P -value Year 2020 (vs 2018) 1.03 0.034 Year 2021 1.08 <0.001 Sex – Female (vs Male) 1.09 <0.001 Black (vs White) 1.33 <0.001 Hispanic 1.08 <0.001 Asian/Pacific Islander 0.79 <0.001 Other race 1.14 <0.001 Medicaid (vs Medicare) 1.10 <0.001 Private insurance 1.13 <0.001 Self-pay 1.17 <0.001 Unspecified 0.77 0.012 Teaching hospital (vs non-teaching) 1.25 <0.001 South (vs Northeast) 0.94 <0.001 West 1.08 <0.001 CCI 1–2 (vs 0) 0.72 <0.001 CCI 3–4 0.85 <0.001 CCI ≥ 5 1.16 <0.001