S3188 Cardiac Complications in Hospitalized Patients With Gastric Cancer: Predictors and Outcomes in a Nationally Representative Sample

Introduction: Gastric cancer accounts for about 1.5% of all new cancers diagnosed in the U.S. each year. Cardiac complications may further worsen prognosis and increase healthcare utilization. We aimed to identify predictors of cardiac complications and assess for any demographic differences between gastric cancer patients who did and did not experience such events. Methods: Using the National Inpatient Sample (2017-2021), we identified adult patients admitted for gastric cancer using the ICD-10 codes. Patients were stratified by whether or not they experienced cardiac complications, including any cardiac complication, heart failure, acute coronary syndrome, and cardiac dysrhythmia. Multivariate regression analysis using Stata 18 was done to analyze any associations between patient/hospital characteristics and cardiac complications. Outcomes included in-hospital mortality, length of stay (LOS), intensive care unit (ICU) admission, and hospital charges. Results: Among 208,734 gastric cancer admissions, 50,567 (24.2%) experienced cardiac complications while 158,167 (75.8%) did not. These patients were generally older (mean age 73.1 years vs 63.5 years; P < 0.001), men (68.7% vs 61.5%; P < 0.001), and disproportionately White (65.2% vs 49.2%; P < 0.001) compared to those without complications. This cohort also had a greater proportion of Charlson Comorbidity Index (CCI) scores >3 (95.3% vs 87.8%; P < 0.001). Compared to Medicare-insured patients, those with Medicaid (adjusted odds ratio [aOR] 0.26; P < 0.001), private insurance (aOR 0.31; P < 0.001), or self-pay (aOR 0.23; P < 0.001) were significantly less likely to experience cardiac events. Independent predictors included older age (aOR 1.06; P < 0.001) and male sex (female aOR 0.73; P < 0.001). Compared to White patients, people of Black (aOR 0.75; P < 0.001), Hispanic (aOR 0.34; P < 0.001), or Asian (aOR 0.49; P < 0.001) race had significantly lower odds of developing any cardiac complication. Cardiac complications were associated with significantly greater odds of mortality (aOR 1.84; P < 0.001), ICU admission (aOR 2.70; P < 0.001), LOS (+1.85 days; P < 0.001), and greater mean hospitalization charges (+$34,306; P < 0.001). Conclusion: Cardiac complications are common in hospitalized patients with gastric cancer and have significant impact on mortality, ICU stay, LOS, and hospital charges. Risk of these events was higher among older, White men. Our study highlights the need for vigilant cardiovascular monitoring and early intervention in this patient cohort.