tetano
Editor, Senior Moderator
Cancer Med
. 2023 Jul 31.
doi: 10.1002/cam4.6355. Online ahead of print. The impact of COVID-19 on mortality, length of stay, and cost of care among patients with gastrointestinal malignancies: A propensity score-matched analysis
Mark B Ulanja[SUP] 1 [/SUP], Bryce D Beutler[SUP] 2 [/SUP], Kwabena Oppong Asafo-Agyei[SUP] 3 [/SUP], Samuel B Governor[SUP] 4 [/SUP], Samuel Edusa[SUP] 5 [/SUP], Daniel Antwi-Amoabeng[SUP] 1 [/SUP], Reginald N Ulanja[SUP] 6 [/SUP], Grace B Nteim[SUP] 6 [/SUP], Millicent Amankwah[SUP] 7 [/SUP], Vijay Neelam[SUP] 1 [/SUP], Ganiyu A Rahman[SUP] 8 [/SUP], Francis T Djankpa[SUP] 6 [/SUP], Tarig Mabrouk[SUP] 1 [/SUP], Olatunji B Alese[SUP] 9 [/SUP]
Affiliations
Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and the coronavirus 19 (COVID-19) pandemic have had a lasting impact on the care of cancer patients. The impact on patients with gastrointestinal (GI) malignancies remains incompletely understood. We aimed to assess the impact of COVID-19 on mortality, length of stay (LOS), and cost of care among patients with GI malignancies, and identify differences in outcomes based on primary tumor site.
Methods: We analyzed discharge encounters collected from the National Inpatient Sample (NIS) between March 2020 and December 2020 using propensity score matching (PSM) and COVID-19 as the treatment effect.
Results: Of the 87,684 patient discharges with GI malignancies, 1892 were positive for COVID-19 (C+) and eligible for matching in the PSM model. Following PSM analysis, C+ with GI tumors demonstrated increased incidence of mortality compared to their COVID-19-negative (C-) counterparts (21.3% vs. 11.9%, p < 0.001). C+ patients with colorectal cancer (CRC) had significantly higher mortality compared to those who were C- (40% vs. 24%; p = 0.035). In addition, C+ patients with GI tumors had a longer mean LOS (9.4 days vs. 6.9 days; p < 0.001) and increased cost of care ($26,048.29 vs. $21,625.2; p = 0.001) compared to C- patients. C+ patients also had higher odds of mortality secondary to myocardial infarction relative to C- patients (OR = 3.54, p = 0.001).
Conclusions: C+ patients with GI tumors face approximately double the odds of mortality, increased LOS, and increased cost of care compared to their C- counterparts. Outcome disparities were most pronounced among patients with CRC.
Keywords: COVID-19; SARS-CoV-2; gastrointestinal cancer; healthcare cost disparity; impact of COVID-19 on gastrointestinal malignancies; mortality; propensity score-matched analysis.
. 2023 Jul 31.
doi: 10.1002/cam4.6355. Online ahead of print. The impact of COVID-19 on mortality, length of stay, and cost of care among patients with gastrointestinal malignancies: A propensity score-matched analysis
Mark B Ulanja[SUP] 1 [/SUP], Bryce D Beutler[SUP] 2 [/SUP], Kwabena Oppong Asafo-Agyei[SUP] 3 [/SUP], Samuel B Governor[SUP] 4 [/SUP], Samuel Edusa[SUP] 5 [/SUP], Daniel Antwi-Amoabeng[SUP] 1 [/SUP], Reginald N Ulanja[SUP] 6 [/SUP], Grace B Nteim[SUP] 6 [/SUP], Millicent Amankwah[SUP] 7 [/SUP], Vijay Neelam[SUP] 1 [/SUP], Ganiyu A Rahman[SUP] 8 [/SUP], Francis T Djankpa[SUP] 6 [/SUP], Tarig Mabrouk[SUP] 1 [/SUP], Olatunji B Alese[SUP] 9 [/SUP]
Affiliations
- PMID: 37519127
- DOI: 10.1002/cam4.6355
Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and the coronavirus 19 (COVID-19) pandemic have had a lasting impact on the care of cancer patients. The impact on patients with gastrointestinal (GI) malignancies remains incompletely understood. We aimed to assess the impact of COVID-19 on mortality, length of stay (LOS), and cost of care among patients with GI malignancies, and identify differences in outcomes based on primary tumor site.
Methods: We analyzed discharge encounters collected from the National Inpatient Sample (NIS) between March 2020 and December 2020 using propensity score matching (PSM) and COVID-19 as the treatment effect.
Results: Of the 87,684 patient discharges with GI malignancies, 1892 were positive for COVID-19 (C+) and eligible for matching in the PSM model. Following PSM analysis, C+ with GI tumors demonstrated increased incidence of mortality compared to their COVID-19-negative (C-) counterparts (21.3% vs. 11.9%, p < 0.001). C+ patients with colorectal cancer (CRC) had significantly higher mortality compared to those who were C- (40% vs. 24%; p = 0.035). In addition, C+ patients with GI tumors had a longer mean LOS (9.4 days vs. 6.9 days; p < 0.001) and increased cost of care ($26,048.29 vs. $21,625.2; p = 0.001) compared to C- patients. C+ patients also had higher odds of mortality secondary to myocardial infarction relative to C- patients (OR = 3.54, p = 0.001).
Conclusions: C+ patients with GI tumors face approximately double the odds of mortality, increased LOS, and increased cost of care compared to their C- counterparts. Outcome disparities were most pronounced among patients with CRC.
Keywords: COVID-19; SARS-CoV-2; gastrointestinal cancer; healthcare cost disparity; impact of COVID-19 on gastrointestinal malignancies; mortality; propensity score-matched analysis.