P3318 - Is Hypoglycemia a Reliable Indicator of Disease Severity in Gastrointestinal Stromal Tumors? Revelations From the National Inpatient Sample

Manasa Ginjupalli, MBBS, MD¹, Jayalekshmi Jayakumar, MBBS, MD², Saigopal R. Gujjula, MD³, Iyad Al-bustami, MD, MPH(c)⁴, Mrunanjali Gaddam, MBBS, MD³, Yashwitha Sai Pulakurthi, MBBS, MD⁵, Vikash Kumar, MD⁶, Praneeth Bandaru, MBBS, MD³, Raja Chandra Chakinala, MD⁷, Vijay Reddy Gayam, MD^8
1The Brooklyn Hospital Center, New York, NY; ²The Brooklyn Hospital Center, Brooklyn, NY; ³Brooklyn Hospital Center, Brooklyn, NY; ⁴Brooklyn Hospital Center, Houston, TX; ⁵Saint Michael's Medical Center, Newark, NJ; ⁶Creighton University School of Medicine, Brooklyn, NY; ⁷Guthrie Robert Packer Hospital, Sayre, PA; ⁸University of Texas Southwestern Medical Center, Dallas, TX

Introduction: Mesenchymal tumors like gastrointestinal stromal tumors (GIST) are often associated with some uncommon paraneoplastic phenomena. Hypoglycemia associated with this non-islet cell tumor is one among them which is caused by the release of insulin-like growth factor type II with significant contribution from cachexia, renal and hepatic dysfunction, and tumoral glucose consumption. With growing literature on hypoglycemia in GIST, we tried to study the in-hospital mortality and morbidity outcomes of GIST patients with hypoglycemia.

Methods: A retrospective analysis was formulated using the National Inpatient Sample database from 2016-2020 and ICD 10 codes were used to identify GIST hospitalizations. This population was stratified based on the presence or absence of hypoglycemia. Categorical variables were compared using chi-square test, while continuous variables were compared using t-test. Multivariable regression analyses were performed to assess the impact of hypoglycemia on mortality and secondary outcomes among GIST hospitalizations, after adjusting for demographics, various patient and hospital-level characteristics, and relevant comorbidities [Table 1].

Results: Out of a total 61725 GIST hospitalizations, 0.72% had hypoglycemia. In this cohort, 49% were females and 50.9% were males. Among hospitalized adults with GIST, mortality rates were 11.2% with hypoglycemia and 3.0% without hypoglycemia. Multivariate regression analysis, after adjusting for confounders, revealed that among GIST hospitalizations, presence of hypoglycemia increased the chance of mortality with an OR 4.16 [2.06-8.37, p-value 0.01]. Hypoglycemia also had a significant impact on secondary outcomes in GIST including malnutrition, sepsis, ascites and peritonitis [Table 1]. Presence of hypoglycemia was also associated with increased length of stay in GIST hospitalizations by 4.61 days. No statistically significant difference in outcomes such as bowel perforation, intestinal obstruction, gastrointestinal bleed were found in GIST hospitalizations with and without hypoglycemia.

Discussion: Despite the low prevalence of hypoglycemia in GIST, its presence was found to have a significant impact on mortality and morbidity outcomes among GIST hospitalizations. Our study recommends the need for prompt management of blood sugars in hospitalized patients with GIST, however further prospective studies are required to establish causation.


Disclosures:


Manasa Ginjupalli, MBBS, MD¹, Jayalekshmi Jayakumar, MBBS, MD², Saigopal R. Gujjula, MD³, Iyad Al-bustami, MD, MPH(c)⁴, Mrunanjali Gaddam, MBBS, MD³, Yashwitha Sai Pulakurthi, MBBS, MD⁵, Vikash Kumar, MD⁶, Praneeth Bandaru, MBBS, MD³, Raja Chandra Chakinala, MD⁷, Vijay Reddy Gayam, MD⁸. P3318 - Is Hypoglycemia a Reliable Indicator of Disease Severity in Gastrointestinal Stromal Tumors? Revelations From the National Inpatient Sample, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.