S676 Clinical Outcomes for Smokers With Early-Onset Colorectal Cancer: Further Analysis of the National Inpatient Sample

Introduction: Despite recent global decreases in overall cancer incidence, the incidence of early-onset colorectal cancer (EOCRC) is steadily increasing in western populations. Limited data is available on the comorbid correlations for this unfortunately expanding population. We sought to examine the national inpatient sample database to describe in-hospital outcomes among smokers with EOCRC. Methods: Data were extracted from the National Inpatient Sample (NIS) Database for 2019 and 2020. The NIS was searched for hospitalizations of adult patients with EOCRC, defined as all-cause colorectal cancer in patients 50 years old or younger. We then examined the outcomes of patients who were noted to be active smokers. Multivariate logistic was used to adjust for confounders. The primary outcome was inpatient mortality. SPSS software was used for statistical analysis. Results: This study included 11,820 patients with EOCRC, of which 1925 (16.3%) were active smokers. Smokers had a slightly higher prevalence of hypertension (4.21% versus 3.90%, P < 0.001) and a slightly lower prevalence of chronic kidney disease (3.90% versus 4.20%, P < 0.001). Multivariate regression showed that smoking patients with EOCRC had higher inpatient mortality (odds ratio [OR] 1.114, CI 1.074-1.156, P < 0.001). On secondary analysis, smoking patients with EOCRC were more likely to have anemia (OR 1.184, CI 1.170-1.119, P < 0.001), thrombocytopenia (OR 1.161, CI 1.128-1.196, P < 0.001), acute renal failure (OR 1.158, CI 1.134-1.183, P < 0.001), acute pancreatitis (OR 1.138, CI 1.058-1.224, P < 0.001), acute pericarditis (OR 1.271, CI 1.130-1.430, P < 0.001), esophagitis (OR 1.231, CI 1.205-1.258, P < 0.001), ulcerative colitis (OR 1.200, CI 1.057-1.362, P < 0.001), Crohn’s disease (OR 1.115, CI 1.053-1.180, P < 0.001), severe liver disease (OR 1.210, CI 1.193-1.228, P < 0.001), all-cause arrhythmias (OR 1.125, CI 1.080-1.173, P < 0.001), all-cause shock (OR 1.076, CI 1.026-1.129, P < 0.001), all-cause heart block (OR 1.179, CI 1.044-1.333, P < 0.001), all-cause sepsis (OR 1.163, CI 1.143-1.184, P < 0.001), all-cause coagulopathy (OR 1.164, CI 1.124-1.205, P < 0.001), all-cause heart failure (OR 1.251, CI 1.179-1.328, P < 0.001), all-cause stroke (OR 1.250, CI 1.176-1.328, P < 0.001), and all-cause myocardial infarction (OR 1.246, CI 1.148-1.351, P < 0.001). Conclusion: In this nationally representative, population‐based retrospective cohort study, smokers with EOCRC were associated with higher mortality and worse outcomes.