S3184 Ascites in Gastric Cancer Hospitalizations: Insights From the Nationwide Inpatient Sample

Introduction: Ascites is a frequent complication in cancer patients, contributing to significant morbidity. Stomach cancer, particularly in advanced stages, is associated with an increased risk of ascites. However, its effect on inpatient outcomes, mortality, and healthcare costs remains unclear. Given the limited literature, understanding how ascites influences clinical and economic outcomes in hospitalized stomach cancer patients is crucial for improving management strategies. Methods: This retrospective cohort study used the 2019 National Inpatient Sample (NIS) to identify adult patients hospitalized with stomach cancer using ICD-10 codes. Patients were categorized into 2 cohorts: those with concurrent ascites and those without. Primary outcome: all-cause in-hospital mortality. Secondary outcomes: pulmonary embolism, septic shock, gastrointestinal hemorrhage, and hospitalization costs. Multivariate logistic regression models were used to adjust for age, sex, comorbidities, and other confounders. Statistical significance was set at P < 0.05. Results: Of 32,695 stomach cancer hospitalizations, 6,455 (19.7%) had concurrent ascites. These patients were older (mean age 66.5 years vs 65.7 years) and predominantly men (74.4%). Surprisingly, ascites was not significantly associated with in-hospital mortality (adjusted odds ratio [aOR] 1.05; 95% CI 0.83-1.31; P = 0.66), pulmonary embolism (aOR 0.79; 95% CI 0.54-1.14; P = 0.2), or septic shock (aOR 1.09; 95% CI 0.82-1.46; P = 0.5). Unexpectedly, ascites was associated with a lower incidence of gastrointestinal hemorrhage (aOR 0.64; 95% CI 0.51-0.80; P < 0.001) and lower hospitalization costs ($75,169 vs $79,069; P < 0.001). Conclusion: Ascites in stomach cancer patients was not associated with increased mortality, pulmonary embolism, or septic shock but was linked to lower rates of gastrointestinal hemorrhage and hospitalization costs. These findings challenge conventional assumptions and suggest that further research is needed to understand the clinical significance of ascites in this population.