P1448 - Unveiling Racial Discrepancies in the Outcomes of Portal Vein Thrombosis Associated With Pancreatic Cancer in the United States

Fnu Vikash, MD¹, Sindhu Vikash, MD¹, Noor Syed, MD², Abu Fahad Abbasi, MD³, Yassine Kilani, MD⁴, Vikash Kumar, MD⁵, Rewanth Katamreddy, MD⁶, Talia F.. Malik, MD⁷, Sunny Patel, MD^8
1Albert Einstein College of Medicine, Jacobi Medical Center, Bronx, NY; ²Santa Clara Valley Medical Center, San Jose, CA; ³Loyola University Medical Center, Maywood, IL; ⁴Lincoln Medical Center, New York, NY; ⁵Brooklyn Hospital Center, Brooklyn, NY; ⁶Saint Michael’s Medical Center, Newark, NJ; ⁷Chicago Medical School at Rosalind Franklin University of Medicine and Science, North Chicago, IL; ⁸Jacobi Medical Center, Albert Einstein College of Medicine, Bronx, NY

Introduction: Portal vein thrombosis (PVT) is a negative prognostic factor in patients with Pancreatic Cancer (PC). Our study is the first to compare the baseline characteristics, hospital utilization, and outcomes associated with PVT in PC patients across different racial groups within the United States (US).

Methods: This is a retrospective longitudinal study of patients with a primary PC diagnosis. We retrieved data from the National Inpatient Sample (NIS) databases from 2016 to 2020 using ICD-10-CM codes. The baseline characteristics of patients were compared using a T-test and Chi-Square. Multivariate regression analysis was applied to estimate the outcomes (length of hospital stay (LOS) and total hospital charges (THC), mortality, and morbidity) while adjusting for confounders. The p-value was set at p < 0.05 for statistical significance.

Results: Among a total of 361,440 adults identified with PC, 4% (N=13,820) had PVT. Whites had the highest rate of PVT among all races (p=0.001). Asians or Pacific Islander patients had a significant increase in total healthcare costs (p=0.006) and Black patients had a higher (3+) Charlson Comorbidity Index (p=0.00) as compared to Whites. Black patients had a higher mean length of stay (5.32 days, p=0.00) though also lower rates of portal hypertension (10.4%, p=0.03) as compared to White patients. Asian patients had the highest rates of ascites (47.4%, p=0.07) and were found to have the highest rate of cardiac arrest (aOR 7.5, p=0.01) followed by Black patients (aOR 4.5 p=0.02). There were no significant differences found in terms of acute liver failure, intestinal infarction, inferior vena cava thrombosis, acute respiratory failure, renal impairment or mortality among all race cohorts.

Discussion: This study demonstrates Asian, Hispanic, and Black patients were disproportionately affected by PVT and its complications in the setting of PC when compared to White patients. While Asian patients had the highest rate of cardiac arrest, Black patients had the longest LOS. This discrepancy may be due in part to Black patients having the highest Charlson Score across races indicating later progression of disease. Additionally, there may be inherent systemic and provider biases or delayed recognition of symptoms of PVT and its complications across different racial groups. Large-scale studies with additional confounders are needed to evaluate better the factors leading to these findings.


Disclosures:


Fnu Vikash, MD¹, Sindhu Vikash, MD¹, Noor Syed, MD², Abu Fahad Abbasi, MD³, Yassine Kilani, MD⁴, Vikash Kumar, MD⁵, Rewanth Katamreddy, MD⁶, Talia F.. Malik, MD⁷, Sunny Patel, MD⁸. P1448 - Unveiling Racial Discrepancies in the Outcomes of Portal Vein Thrombosis Associated With Pancreatic Cancer in the United States, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.