S628 A Dual Diagnosis, a Double Burden: Racial and Ethnic Disparities in Colorectal Cancer and Cardiovascular Diseases-Related Hospital Outcomes

Introduction: Cardiovascular disease (CVD) and colorectal cancer (CRC) are major contributors to morbidity and mortality in the United States, with evidence suggesting disproportionately adverse outcomes among racial and ethnic minorities. However, limited national data exist on how race and ethnicity influence the cardiovascular burden and related in-hospital outcomes in patients with CRC. We evaluated racial disparities in in-hospital mortality, length of stay (LOS), and healthcare costs among patients hospitalized with concurrent CRC and CVD. Methods: A retrospective cross-sectional analysis of the National Inpatient Sample from 2018 to 2020 was conducted, identifying 232,720 adult hospitalizations with a primary diagnosis of CRC and a secondary diagnosis of at least one CVD, defined as myocardial infarction, dysrhythmia, coronary artery disease, heart failure, hypertension, or stroke. Multivariable logistic and linear regression models were used to evaluate the association between race/ethnicity and in-hospital outcomes, including mortality, LOS, and total hospitalization costs, adjusting for patient demographics, clinical comorbidities, and hospital characteristics. Results: Among the 232,720 hospitalizations analyzed, 71.7% of patients were identified as White, 13.7% as Black, 8.3% as Hispanic, 3.3% as Asian/Pacific Islander, and 3.0% as Other. Black patients exhibited significantly higher in-hospital mortality (odds ratio [OR]: 1.33; 95% CI: 1.12–1.58; P = 0.001), extended LOS (β = 0.97 days; 95% CI: 0.74–1.20; P < 0.001), and elevated costs (β = $4,695; 95% CI: $1,424–$7,966; P = 0.005) than Whites with CVD and CRC. Hispanics experienced the highest inflation-adjusted hospital charges (β = $20,281; 95% CI: $14,787–$25,776; P < 0.001) alongside a moderately prolonged LOS (β = 0.37 days; 95% CI: 0.10–0.64; P = 0.006). Asians were disproportionately affected by rectal cancers (22%), while their Black and Hispanic counterparts demonstrated higher rates of anus and anal canal cancers (2.6% and 2.5%, respectively). Metastatic disease prevalence was greatest amongst the Black (40%) and Asian (35%) population. Conclusion: Racial disparities in in-hospital outcomes among patients with concurrent colorectal cancer and cardiovascular disease are pronounced. Black and Hispanic patients experience significantly higher mortality, longer hospital stays, and greater healthcare costs compared to Whites. These findings highlight an urgent need for equity-focused strategies to address these structural and clinical inequities.