P3835 - Impact of Systemic Anticoagulation on Inpatient Outcomes in Hepatocellular Carcinoma: Evidence from the US Nationwide Inpatient Sample

Sheza Malik, MD¹, Yasir R. Rajwana, MD², Faisaluddin Mohammed, MD¹, Ese Uwagbale, MD¹, Asim Mushtaq, MD^1
1Rochester General Hospital, Rochester, NY; ²Stanford Healthcare, Palo Alto, CA

Introduction: Hepatocellular carcinoma, one of the most common gastrointestinal cancer, can cause a hypercoagulable state leading to thrombosis, but the role of anticoagulants is unclear. This study examines the effects of long-term systemic anticoagulant use on hospitalization outcomes in patients with hepatocellular carcinoma (HCC).

Methods: In this retrospective study, data were extracted from the U.S. Nationwide Inpatient Sample (NIS) database spanning from 2015 to 2020. We focused on hospitalized adults aged 18 years and older diagnosed with hepatocellular carcinoma using the International Classification of Diseases' ninth and tenth revisions (ICD-9 and ICD-10) codes. The study cohort was divided into two groups based on long-term systemic anticoagulant use, and propensity score matching was employed to balance group characteristics. Univariable and multivariable logistic regression analyses were conducted to compare the risks of life-threatening events (e.g., acute heart failure, sepsis, shock, acute kidney injury), in-hospital mortality, length of stay, and total hospitalization cost between the groups.

Results: The study population consisted of 451,815 hospitalized patients with HCC, 6.21% (n = 28,065) of whom were on long-term systemic anticoagulants. Multivariable regression analysis showed that long-term systemic anticoagulant use was independently associated with lower odds of AHF (aOR: 0.89, 95% CI:0.81-0.98), sepsis (aOR: 0.81, 95% CI: 0.77–0.85), shock (aOR: 0.58, 95% CI: 0.52–0.64), AKI (aOR: 0.83, 95% CI: 0.79–0.86), in-hospital mortality (aOR: 0.58, 95% CI: 0.54–0.63), and prolonged LOS with concomitant increase total hospitalization cost.

Discussion: Long-term systemic anticoagulant use in hospitalized patients with hepatocellular carcinoma in the U.S. is linked to improved clinical outcomes, including reduced risks of life-threatening events, in-hospital mortality, and prolonged length of stay.


Disclosures:


Sheza Malik, MD¹, Yasir R. Rajwana, MD², Faisaluddin Mohammed, MD¹, Ese Uwagbale, MD¹, Asim Mushtaq, MD¹. P3835 - Impact of Systemic Anticoagulation on Inpatient Outcomes in Hepatocellular Carcinoma: Evidence from the US Nationwide Inpatient Sample, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.