A Multi-State Cohort Study of Hospital Utilization and Treatment Modality for Malignant Gastrointestinal Obstructions

Area of Science:

• Oncology
• Gastroenterology
• Surgical Oncology

Background:

• Malignant obstructions significantly impact patient morbidity, mortality, and quality of life.
• Limited population-based data exist on practice patterns for managing malignant obstructions.
• Understanding factors influencing treatment is crucial for improving patient outcomes.

Purpose of the Study:

• To investigate the association between prior cancer-related hospitalizations and the likelihood of receiving operative treatment for malignant gastrointestinal obstructions.
• To analyze how the number of previous hospitalizations affects surgical intervention for malignant obstructions.
• To provide data on treatment trends for patients with malignant obstructions.

Main Methods:

• Retrospective cohort study utilizing the Healthcare Cost and Utilization Project State Inpatient Database (2016-2020).
• Included patients with malignant gastrointestinal obstructions from colorectal, gynecologic (GYN), and hepato-pancreatico-biliary (HPB) cancers.
• Primary exposure: number of cancer-related hospitalizations in the year preceding obstruction hospitalization; analyzed operative treatment, hospice enrollment, length of stay, and inpatient mortality.

Main Results:

• A total of 8665 patients were analyzed; 24.1% received operative treatment.
• Patients with prior hospitalizations were less likely to undergo surgery (-7.8% difference, p<0.001).
• Operative treatment correlated with longer hospital stays, lower hospice enrollment, and reduced inpatient mortality.

Conclusions:

• Increased prior cancer hospitalizations are linked to decreased rates of operative treatment for malignant obstructions.
• These findings offer insights into current treatment trends for malignant obstructions.
• The data can assist in counseling patients regarding the disease's natural progression and treatment options.