e16020 Background: Gastric cancer patients are vulnerable to non-variceal upper gastrointestinal bleeding, a complication that worsens clinical outcomes. Acute kidney injury (AKI) can develop in the setting of gastrointestinal bleeding due to intravascular volume loss and associated hypotension. This study explores the incidence, predictors, mortality, and overall healthcare burden of AKI in gastric cancer patients presenting with non-variceal upper gastrointestinal bleeding (NVUGIB). Methods: The 2016-2022 National Inpatient Sample (NIS) was queried to identify adult hospitalizations with NVUGIB in gastric cancer patients using ICD-10-CM codes. Patients with COVID-19 and those younger than 18 years were excluded. Multivariable logistic regression was performed to identify independent predictors of AKI. Outcomes including in-hospital mortality, need for hemodialysis, length of stay, and hospital charges were compared between AKI and non-AKI groups using appropriate statistical tests. Results: Among 5, 135 hospitalized patients with NVUGIB in the setting of gastric cancer, 990 (19. 28%) developed AKI. Patients with AKI were significantly older than those without AKI (mean age 71. 92 vs 66. 46 years, p < 0. 001). On multivariable logistic regression analysis, advancing age (AOR 1. 029 per year, 95% CI 1. 010-1. 047, p = 0. 002), pre-existing chronic kidney disease (CKD) (AOR 2. 572, 95% CI 1. 684-3. 926, p < 0. 001), chronic obstructive pulmonary disease (COPD) (AOR 1. 917, 95% CI 1. 167-3. 150, p = 0. 01), and cirrhosis (AOR 1. 732, 95% CI 1. 015-2. 956, p = 0. 044) were significant predictors of AKI development. Other demographic and clinical variables including sex, race, insurance status, weekend admission, and comorbidities such as diabetes, hypertension, congestive heart failure, and metastatic cancer were not significantly associated with AKI risk. Patients with AKI had more than three-fold higher odds of in-hospital mortality compared to those without AKI (AOR 3. 277, 95% CI 1. 728-6. 216, p < 0. 001). Among patients who developed AKI, 2. 53% required hemodialysis during hospitalization. Mean length of stay was significantly longer in the AKI group (7. 05 vs 4. 64 days, p < 0. 001), and mean hospital charges were nearly double (116, 225 vs 63, 164, p < 0. 001). Conclusions: AKI was present in nearly one-fifth of gastric cancer patients admitted for NVUGIB and was associated with substantial mortality and healthcare utilization. Risk stratification measures in patients with pre-existing chronic kidney disease, COPD, cirrhosis, and advancing age may help mitigate such events and improve outcomes.
Savani et al. (2026) studied this question.