06.09 Understanding Effects of Age Race & Socioeconomic Status on Outcomes in Patients with Colon Cancer

Posted on January 25, 2017

O. O. Osuchukwu1, V. Pandit1, S. W. Mbugua1, J. Jandova1,2, A. Cruz1, V. N. Nfonsam1  1University Of Arizona,Surgery,Tucson, AZ, USA 2University Of Arizona,Institute For Cellular Transplant,Tucson, 85724, USA

Introduction:

Differences in outcomes among patients based on demographic and racial profile are well established. However; the impact of these differences on patient outcomes with colon cancer (CC) remains unclear. We hypothesized that racial and demographic profile is associated with adverse outcomes among patients with CC.

Methods:
National estimates for patients with CC were extracted from the National Inpatient Sample (NIS) database (2011). Patients were stratified based on age, race and insurance status. Outcome measures were: hospital length of stay (LOS), complications, and mortality. Regression analysis was performed after adjusting for age, gender, race, Charlson co-morbidity index (CCI), and type of surgical intervention.  

Results:
A total of 37,513 patients with CC were analyzed. The mean age was 68.3±13.9 years, 51.1% were females and the mean CCI was 2 [2-3]. Sixty-five and half percent of patients were white and 67.3% were Medicare/Medicaid insured. The overall mortality rate was 4.6%. Mortality rate significantly increased (p=0.04) with increasing age. Native Americans had the highest mortality rate and complication rate among all races. On regression analysis, increasing age (OR: 1.6 [1.1-3.1]), being non-white (OR: 1.3 [1.2-2.7]), and Medicare/Medicaid insurance status (OR: 1.2 [1.05-3.8]) were independently associated with mortality. Additionally, increasing age (OR: 1.9 [1.3-4.4]) and non-white race (OR: 1.4 [1.05-2.9]) were associated with increased in-hospital complication.

Conclusion:

Demographic, racial and socio-economic disparities are prevalent among patients with CC with worse outcomes among old and non-white patients. Native American patients with CC have worse outcomes among all races. Further assessing the causes for these disparities may help mobilization of resources and improve outcomes among patients with CC.