Trends in lung resection and inpatient mortality among U.S. lung cancer patients (2010–2022).

e23106 Background: Despite declining lung cancer incidence and mortality in the United States, disparities in treatment utilization and outcomes persist across demographic and socioeconomic groups. We examined national trends and disparities in surgical treatment and inpatient mortality among hospitalized lung cancer patients. Methods: We analyzed National Inpatient Sample from 2010 to 2022. Adult admissions with a primary diagnosis of lung cancer were identified using ICD codes. Lung resection was defined by having a procedure during the same admission. Hospitalizations, lung resection utilization and inpatient mortality were examined overall and stratified by age, sex, race utilizing survey-weighted analyses. Multivariate logistic regression adjusted for age, sex, ethnicity, household income, comorbidities, hospital characteristics, and insurance type. Results: A total of 7,069,033 hospitalizations with a primary diagnosis of lung cancer were identified over 13 years. A decreasing trend of hospitalization numbers was seen over the period (736,075 in 2010 vs 381,080 in 2022). Females accounted for 49.1% of admissions with an increasing trend with odds ratio (OR) 1.015 (95% CI 1.013 - 1.017, P < .001).Lung resection utilization increased overtime with OR 1.042 (95% CI 1.033 - 1.050, P < .001). Compared with Whites, surgical utilization was lower among Blacks and Hispanics (aOR 0.594 and 0.880, all P < .001). Resection rates were higher among females than males (aOR 1.096, P < .001), lowest in the lowest income quartile, and higher in the 2nd, 3rd, and 4th income quartiles (all P < .001). Surgical utilization was also lower among Medicaid and self-pay patients compared with Medicare beneficiaries (all P < .001).A decreasing trend of inpatient mortality was noted (aOR 0.934; 95% CI 0.930–0.938; p < 0.001) and was seen in examined ethnic groups, when stratified into White (aOR 0.938), Black (aOR 0.939) and Hispanic (aOR 0.938) (all P < .001) with no difference in mortality trends. However, overall mortality remained higher among Blacks (aOR 1.069) and Asian/Native Americans (aOR 1.141), patients with Medicaid, private insurance, or self-pay compared to those with Medicare (all P < .001). Conclusions: Lung cancer hospitalizations and inpatient mortality declined from 2010 to 2022, while lung resection utilization increased. However, disparities in surgical treatment utilization and mortality remain across racial and insurance groups. Targeted efforts are needed to reduce these disparities and improve equity.