2433 - Demographics, Disparities and Clinical Outcomes in Radiation Pneumonitis Hospitalizations with and without Lung Cancer: Retrospective Analysis of National Inpatient Sample (NIS)
Presenter(s)
T. A. Mathew1, T. Varghese2, A. Khosla3, G. M. Varghese4, M. Gevorgian5, and R. Jacob6; 1Southeast Health, Dothan, AL, 2Wellstar Spalding Hospital, Spalding, GA, 3Louisana State University, Louisana, LA, 4Stanford University, San Francisco, CA, 5Alabama College of Osteopathic Medicine, Dothan, AL, United States, 6University of MIssissipi Medical Center, Mississipi, MS
Purpose/Objective(s): Radiation pneumonitis (RP) is an inflammatory condition of the lungs triggered by radiation, often presenting symptoms such as a dry cough, difficulty breathing, and chest pain. RP is often underdiagnosed and usually mimics pneumonia of immunocompromised hence the treatment with corticosteroids can be delayed. Our aim is to identify the demographics, disparities, and clinical outcomes in RP hospitalizations to allow timely diagnosis and treatment.
Materials/Methods: The 2022 NIS was utilized to identify hospitalizations of radiation pneumonitis, both with and without lung cancer. The hospitalization characteristics and clinical outcomes of RP were compared using T-test and Chi-square.
Results: Of the total 2642 inpatient hospitalizations with RP in 2022, 865 patients had lung cancer, and the remaining 1777 received radiation for other malignancies. The mean age of RP with and without lung cancer was 70 and 63 years respectively (p-value 0.00). Among those with RP and lung cancer, 78% were White, 11% were Black, 5% were Hispanic, and 5% were Asian or Pacific Islander. In contrast, of those with RP without lung cancer, 72% were White, 14% were Black, 9% were Hispanic, and 3% were Asian or Pacific Islander. There were no gender disparities observed in these study populations. It was observed that mortality rates were significantly higher (14%) in RP patients with lung cancer when compared to those without lung cancer (10.02%) with a p-value of 0.00. The odds ratio of pulmonary embolism and respiratory failure were high in RP with lung cancer, OR =2.04, 95% CI=1.4- 2.8, p-value 0.00 and OR=1.4 95% CI 1.2-1.9 p-value 0.03 respectively. 2034 RP patients were treated in teaching hospitals vs 608 were treated in non-teaching hospitals. 80% of RP with lung cancer were managed in teaching hospitals and 20% in non-teaching hospitals. 75.52% of those without lung cancer received care at teaching hospitals while 24.48% received care at non-teaching hospitals. RP with lung cancer had a higher proportion of Medicare coverage (70%) vs those without lung cancer (58%), a p-value of 0.00. The mean total charges were higher in RP without lung cancer ($ 124128.8) vs. with lung cancer ($ 99734.4). There was no statistically significant difference in the length of stay in the study populations.
Conclusion: RP is more common in patients who received radiation for malignancies other than lung cancer. However, mortality is higher in those with lung cancer. Thus highlighting the importance of early identification and timely intervention.