In-hospital outcomes of acute pulmonary embolism admissions in individuals with genitourinary cancers: Insights from a national population study in the United States.

e16581 Background: Management of acute pulmonary embolism (PE) in patients with genitourinary (GU) malignancies is usually challenging. It is usually associated with adverse outcomes and can significantly contribute to morbidity and mortality and detrimentally impacts quality of life among cancer patients. There has been scarce previous national population study on patients with PE and GU malignancies. Here, we studied the rate of readmissions and mortality for patients admitted for PE with GU cancers in the U.S. and its burden on health care system. Methods: Utilizing the Nationwide Readmissions Database (NRD), we conducted a retrospective cohort study on patients admitted with PE and segregated the individuals with GU cancers (GUC) including renal cell carcinoma (RCC), urothelial Carcinoma (UC), prostate cancer (PCa), testicular cancer (TC), and penile cancer (Pen Ca) between 2016 and 2019 across the United States. We used multivariable logistic regression to determine the predictors of unplanned readmissions within 30 days and mortality. Results: A total of 402,054 patients hospitalized with PE and 44,373 (11%) were readmitted within the next 30 days. Mean length of stay was 4.64 days (95% CI 4.62-4.65). Total charge for index hospitalization was $51,409 (95% CI 51,174-51,643). A total of 8,998 patients were found to have GU cancers. Following baseline comorbidities were associated with highest risk of readmission: Atrial fibrillation, proximal and caval deep vein thrombosis, obesity, hypertension, smoking, and diabetes mellites ( P <0.001). Among GUC, rate of readmission was highest for UC (P<0.01; OR 2.49, 95% CI 1.76 - 3.5) as shown in the table. Risk of in hospital mortality was also highest for UC (P<0.01; OR 2.40, 95% CI 1.39-4.14) followed by RCC (P<0.01; OR 2.06, 95% CI 1.62-2.5). Conclusions: There was higher risk of readmission and mortality for patients with GU malignancies who were hospitalized for PE. UC was the leading GU cancer for rate of readmission and mortality. These readmissions were lengthy and costly for the health care system. This study suggests that more aggressive intervention might be needed in this population to prevent readmission and mortality. [Table: see text]