SHM Converge Scientific Abstract ePoster Gallery-Social Determinants of Health and the Risk of Perforation, Peritonitis, and Sepsis in Gastrointestinal Malignancies: A National Inpatient Sample Analysis

Social Determinants of Health and the Risk of Perforation, Peritonitis, and Sepsis in Gastrointestinal Malignancies: A National Inpatient Sample Analysis

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This national inpatient study examined whether social determinants of health (SDOH) influence the risk of serious acute complications in gastrointestinal (GI) cancers, including perforation/peritonitis and sepsis/septic shock, and how these complications affect hospital outcomes.<br /><br />Using the National Inpatient Sample from 2018–2021, the authors analyzed adults with GI malignancies identified by ICD-10 codes and grouped cancers into esophageal, gastric, small bowel, colorectal, hepatobiliary, pancreatic, and other GI sites. The main outcomes were inpatient perforation/peritonitis and sepsis/septic shock. Predictors included age, sex, race, income quartile, insurance type, and cancer site. Secondary outcomes were length of stay, hospital charges, and discharge disposition.<br /><br />Key findings showed important disparities. For perforation/peritonitis, Black and Hispanic patients had slightly lower odds, while Medicaid and self-pay patients had higher odds. Risk also varied by cancer type, with small bowel cancers showing the highest increase. For sepsis, Black, Hispanic, Asian, and other racial groups had higher odds, while private insurance and no-charge encounters were associated with lower odds. Septic shock showed similar patterns to sepsis.<br /><br />Overall, the results indicate that insurance status, income, and race are associated with differing risks of life-threatening GI cancer complications and with variation in hospital resource use and post-acute care needs. The study suggests that structural barriers contribute to delayed diagnosis and worse inpatient outcomes. The authors conclude that targeted interventions to reduce diagnostic delays, improve access to outpatient oncology care, and address financial and geographic barriers are needed to reduce inequities and improve outcomes for patients with GI malignancies.

Asset Subtitle

Niketh Chopra

Meta Tag

Author List David Leroy, Elaine Ognjanovski, Krishna Kothamasu, Mustafa Naveed, Niketh Chopra, Rafael Barretto

Category Research

Concept Social Determinants of Health

Concept Gastrointestinal Malignancy

Concept Perforation

Concept Peritonitis

Concept Sepsis

Distinguished Non-Finalist

Presenter Organization Henry Ford Warren Internal Medicine

Presenting Author Niketh Chopra

Track Outcomes Research

Keywords

gastrointestinal cancers

social determinants of health

inpatient complications

perforation peritonitis

sepsis septic shock

health disparities

insurance status

race and ethnicity

National Inpatient Sample

hospital outcomes

Social Determinants of Health

Gastrointestinal Malignancy

Perforation

Peritonitis

Sepsis