Trends, outcomes, and disparities in lung cancer–related hospitalizations in the United States: 2012–2022.

e20112 Background: Lung Cancer remains a leading cause of morbidity and mortality in the United States and accounts for significant inpatient and emergency department services utilization. Advances in Lung Cancer treatment have resulted in improvement of survival after diagnosis. However, the impact on inpatient services utilization and inpatient outcomes remains unclear. Methods: We performed a retrospective analysis of lung cancer-related hospitalizations (LCHs) using the National Inpatient Sample from 2012 to 2022. LCHs were identified using ICD-9 and ICD-10 diagnosis codes. Hospitalization rates were calculated per 100,000 U.S. population and analyzed over time using Poisson regression. The primary outcome was in-hospital mortality (IHM). Secondary outcomes included length of stay, hospitalization costs, discharge disposition, and primary non-cancer reason for hospitalization. Univariate and multivariate logistic regression were used to identify factors associated with IHM. Results: A total of 4,399,594 LCH were identified from 2012-2022. The median age was 69 years (IQR 62–77), and 51.3% of hospitalizations occurred among males. Overall LCHs rates increased modestly over time (IRR 1.01; 95% CI 1.00–1.01; p < 0.001) relative to general hospitalizations, with a notable decrease in 2020, resembling declines in general hospitalizations during this period. IHM rates had shown a tendency to decline prior to 2020 (IRR = 0.99; p < 0.001; 95% CI = 0.98-0.99), with a steady increase in subsequent years (p < 0.001; IRR = 1.05; 95% CI = 1.04-1.06) Mortality rates were higher among males, Asian/Pacific Islanders, Native Americans, and Hispanics. Median length of stay was 4 days (IQR 3–8). Median hospitalization cost was $42,983 (IQR $22,437–$80,557), with higher costs among Hispanics and Asian/Pacific Islanders. In adjusted analyses, increasing age (aOR 1.02 per decade), male sex (aOR 0.81 for females), Asian/Pacific Islander ethnicity (aOR 1.10), cirrhosis (aOR 1.57), and chronic kidney disease (aOR 1.16) were independently associated with increased IHM (p < 0.001). Treatment at urban teaching hospitals (aOR 0.91) was associated with reduced IHM (p < 0.001). Conclusions: During a decade marked by major therapeutic breakthroughs, LCH rates increased modestly. Despite a prepandemic decline, IHM has recently shown a steady increase. Length of stay and hospitalization costs remain substantial, with persistent disparities across demographic and clinical subgroups. Despite improvements in lung cancer patients' survival, the inpatient burden of lung cancer seems to be increasing. Targeted efforts to optimize inpatient management, address comorbidity burden, and reduce structural inequities are needed to further improve outcomes in the modern treatment era.