Abstract Introduction Pneumocystis jirovecii pneumonia (PJP) is a significant opportunistic infection in immunocompromised patients. While cancer patients experience significant immunosuppression that increases their susceptibility to PJP, outcomes of this infection stratified by specific tumor types remain poorly characterized. Methods This retrospective study identified adults with PJP and either solid or hematologic malignancies using the National Inpatient Sample (2016-2022). Exclusion criteria included age 18 years, COVID-19 positivity, concurrent solid and hematologic malignancies, HIV positivity, or missing data. Baseline characteristics were compared between the two cancer groups. Multivariable regression analyses, adjusting for potential confounders, were conducted to estimate adjusted odds ratios for adverse events, treatments, and mortality. All analyses accounted for the complex survey design of the dataset. Results We found 11565 admissions involving PCP matching our selection, with 55. 6% (6430) liquid and 44. 4% (5135) solid cancers. Both groups contained an elderly population (mean age in solid: 64. 25 years, vs. mean age in liquid: 63. 36 years, p = 0. 139), and mostly males (51. 32% of solid and 66. 33% of liquid cancers, p 0. 01). The adjusted Deyo Charlson Comorbidity Index Scores were also comparable (1. 65 in solid vs. 1. 55 in liquid cancers, p = 0. 195). Majority of patients in both groups (73. 97% of solid and 72. 55% of liquid) were Whites (p = 0. 155), insured via Medicare (52. 98% of solid and 54. 60% of liquid, p=0. 580), and hospitalized at urban teaching centers (85. 69% of solid and 87. 17% of liquid, p = 0. 341). Among patients with solid tumors, 32. 03% were respiratory/thoracic cancers, 11. 88% were breast cancers, 11. 10% were gastrointestinal cancers. Among patients with hematologic malignancies, the most common diagnoses were lymphoma (48. 4%) followed by leukemia (37. 2%). Patients with hematologic malignancies recorded reduced rates of acute respiratory failure, mechanical ventilation requirements, and intubation. In contrast, no significant differences were observed between groups for cardiovascular complications including cardiac arrest and septic shock. Acute kidney injury odds were similarly comparable between the two cohorts (Table 1). Our analysis demonstrated significantly lower mortality in hematologic malignancy patients compared to solid tumor patients, but with longer lengths of stay (15. 4 days vs 13. 2 days) and higher hospital charges (234, 616 vs 188, 792). Conclusions Our findings demonstrate that solid malignancies may pose a bigger threat to PJP outcomes as compared to hematological cancers, warranting further investigation to set up appropriate preventive strategies and treatment protocols. This abstract is funded by: None
Singh et al. (Fri,) studied this question.
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