Inpatient Outcomes of Pancreatic Cancer Surgery in Patients with Coronary Artery Disease

Background: Coronary artery disease (CAD) is an important comorbidity that may increase perioperative cardiovascular risk in major noncardiac surgery. However, data evaluating its impact on outcomes following pancreatic cancer surgery remain limited. This study evaluated inpatient outcomes among patients undergoing pancreatic cancer resection with versus without CAD in the United States. Methods: We performed a retrospective analysis using the National Inpatient Sample (2016–2022). Adult hospitalizations with ICD-10 diagnosis codes for pancreatic cancer and procedure codes for pancreatic resection were identified and stratified by the presence of CAD. The primary outcome was in-hospital mortality. Secondary outcomes included length of stay, hospitalization cost, and complications such as shock, respiratory failure, acute kidney injury, and transfusion. Results: A total of 49,395 hospitalizations were identified, including 6910 (14.0%) with CAD. Patients with CAD were older and had a greater comorbidity burden. In-hospital mortality was similar between groups (2.32% vs. 2.34%). Most complications were comparable, although shock was more frequent in CAD patients (6.66% vs. 5.44%). Length of stay was similar, while hospitalization costs were modestly higher in the CAD cohort. Conclusions: Pre-existing CAD was not associated with increased in-hospital mortality or longer hospitalization following pancreatic cancer surgery despite a greater comorbidity burden.