e23097 Background: Among patients with cancer, sepsis is a leading cause of hospitalization and mortality. Data on clinical outcomes, resource use, and palliative care utilization (PC) across hematologic (HM) and solid malignancies (SM) in sepsis-associated hospitalizations needs to be elucidated. We aimed to characterize these patterns in a nationally representative cohort. Methods: We analyzed adult cancer-associated sepsis hospitalizations from the National Inpatient Sample (2016–2022). HM, SM, metastatic malignancies (MM), and PC use were identified via ICD-10 codes. Outcomes included in-hospital mortality (IHM), length of stay (LOS), and total hospital charges (THC). Survey-weighted logistic and linear regression models evaluated factors associated with IHM. Adjusted odds ratios (aOR) reflect comparisons to cohort mean after multivariable adjustment. Results: Among 82, 471 cancer-associated sepsis hospitalizations, 72. 4% were SM and 27. 6% HM. HM hospitalizations had lower mean age (64. 7 vs 67. 4 years), longer LOS (12. 1 vs 9. 2 days), higher THC (194, 507 vs 131, 622), and lower PC use (21. 6% vs 27. 9%, aOR 0. 72). MM hospitalizations accounted for 43. 6%; patients were younger (66. 2 vs 67. 1 years) and more often female (46. 2% vs 41. 5%). Multivariable regression adjusted for demographics, organ dysfunction and septic severity (Table1) revealed older age (aOR 1. 01), Black race and lower ZIP income quartile were independent predictors for higher IHM. Teaching hospital status and PC predicted lower IHM. Among HM, leukemia had highest IHM (aOR 1. 22), myeloma had prolonged LOS (aOR 1. 55), and lymphoma had greater sepsis severity (SS) (aOR 1. 48). Among SM, thoracic (1. 18) and CNS (1. 14) tumors had highest IHM; CNS tumors had greater SS (1. 28) and prolonged LOS (1. 34), followed by sarcoma/bone tumors (SS 1. 22; LOS 1. 29). Acute kidney injury (aOR 1. 51), acute respiratory failure (3. 00) and septic shock (2. 88) were independently associated with increased IHM across all cancers. PC was associated with shorter LOS in both HM and SM (−1. 37 and −2. 68 days, respectively) and lower THC (adjusted difference −6, 682) overall. All p < 0. 001. Conclusions: Cancer-associated sepsis outcomes differ by malignancy type and socio-demographic factors. Persistent inequities by race and socioeconomic status highlight the need for equitable resource allocation, expanded access to academic centers, and comprehensive palliative care integration. In-hospital mortality regression analysis. Predictor: aOR (95% CI) HM SM MM p-value Black race vs White 1. 36 (1. 21–1. 52) 1. 42 (1. 28–1. 56) 1. 38 (1. 25–1. 51) <0. 001 ZIP income quartile (Q1 vs Q4) 1. 08 (1. 04–1. 12) 1. 12 (1. 07–1. 18) 1. 10 (1. 05–1. 15) <0. 001 Teaching hospital 0. 91 (0. 85–0. 97) 0. 94 (0. 89–0. 99) 0. 92 (0. 87–0. 98) ≤0. 015 PC 0. 63 (0. 57–0. 70) 0. 68 (0. 62–0. 74) 0. 70 (0. 65–0. 76) <0. 001
Pattnaik et al. (Thu,) studied this question.