S56 Clinical Predictors of In-Hospital Mortality in Female Patients With Pancreatic Cancer: Insights From a Nationwide Database

Introduction: Pancreatic cancer has high morbidity and mortality, with increasing incidence among women in the United States; however, data on the in-hospital outcome remain limited. We aimed to identify predictors of these outcomes to inform clinical management. Methods: The National Inpatient Sample database from 2016 to 2020 was utilized to assess demographic and clinical factors associated with in-hospital mortality among women ≥18 years with pancreatic cancer. We used multivariable logistic regression to examine patient characteristics and clinical outcome predictors, estimating adjusted odds ratios (aORs) for age, ethnicity, income, insurance, hospital size, region, and teaching status. Results: 544,864 hospitalized patients had pancreatic cancer, 260,644 (48%) were women (69 ± 0.06 years), 7% (19,288) inpatient deaths. The mean length of stay was 6 days, and mean total adjusted hospital charges were $71,454. Each 1-year increase in age was associated with a 2% higher chance of in-hospital death (aOR 1.02; P < 0.001). Compared to White patients, Black patients had a slightly increased risk of mortality (aOR 1.1; P = 0.1), as did Asians (aOR 1.24; P = 0.002), while Hispanics had significantly lower chance of dying in the hospital (aOR 0.82; P = 0.02). Interestingly, patients with anemia had 24% lower odds of mortality (aOR 0.76; P < 0.001) while those with acute kidney injury (aOR 2.6; P < 0.001), ascites (aOR 2.3; P < 0.001), and hypoglycemia (aOR 2.5; P < 0.001) were more than twice as likely to die during hospitalization. Coagulopathy (aOR 1.6; P < 0.001), and PE (aOR 1.9; P < 0.001) were also strongly linked to death. Those who underwent intubation during hospitalization had a fivefold increase in risk of mortality (aOR 5; P < 0.001). Similarly, mechanical ventilation (aOR 2.7; P < 0.001) and vasopressor use (aOR 2.2; P < 0.001) significantly increased mortality risk. The strongest predictor of death was sepsis, with over a threefold increase in mortality risk (aOR 3.3; P < 0.001). Conclusion: Several clinical and demographic factors were noted to significantly influence in-hospital mortality among women with pancreatic cancer. Sepsis was the most critical complication and intubation the major procedure predicting death. Surprisingly, anemia was associated with lower mortality, warranting further study into understanding this association. These findings highlight the importance of early identification and prompt management of high-risk complications to improve survival outcomes in this population.