P3660 - A First Look Into Frailty’s Impact on Complications in Patients With Radiation Proctitis via the 2016-2020 National Inpatient Sample

Lily Liu, BS¹, Renuka Verma, MD², Kyaw Min Tun, DO³, Hemamalini Sakthivel, MD⁴, Kamleshun Ramphul, MD⁵, Banreet Dhindsa, MD^6
1Kirk Kerkorian School of Medicine at the University of Nevada, Las Vegas, NV; ²University of Nevada, Las Vegas, NV; ³Creighton University School of Medicine, Las Vegas, NV; ⁴One Brooklyn Health-Interfaith Medical Center, New York, NY; ⁵Independent Researcher, Triolet, Pamplemousses, Mauritius; ⁶NYU Grossman School of Medicine, New York, NY

Introduction: Radiation proctitis(RP) is a complication secondary to radiation treatment for cancers of the pelvis. Despite the growing literature on the influence of frailty on outcomes and complications of cancer treatment, there is currently no data highlighting the potential impact of frailty on RP. Our study aims to bridge the knowledge on this topic with the use of national records.

Methods: Our retrospective observational study focused on discharge records from the 2016-2020 National Inpatient Sample(NIS). Adults with an ICD-10 code for RP(K62.7) were retained. The patients were further categorized based on Gilbert’s Frailty Scoring Index as low frailty risk (LFR) (score < 5), medium frailty risk (MFR)( score 5-15), and high frailty risk (HFR) (score >15). Chi-square tests and ANOVA were used to compare multiple patient characteristics between the three groups. Multivariable regression models were applied to evaluate the impact of frailty on various complications.

Results: We found 42980 patients with a diagnosis code for RP in our study, amongst which 48.2% (20700 cases) were classified as LFR, 48.3% (20780 cases) as MFR, and 3.5% (1500 cases) as HFR, with increasing mean ages between the three groups (mean age of 70.92 in LFR, 72.69 in MFR, and 76.57 in HFR). Multiple differences in patient characteristics and the presence of numerous comorbidities were found between the three groups, as described in Table 1. Furthermore, an increasing frailty grade was also linked with higher odds of multiple adverse effects, such as severe sepsis without septic shock, severe sepsis with septic shock, events of cardiac arrest, need for invasive mechanical ventilation, events of acute deep vein thrombosis, acute kidney injury, and all-cause mortality. However, we found that with increasing Frailty scores, the odds of reporting events of hemorrhage of the rectum or anus were lower. No statistically significant differences were noted for events of acute pulmonary embolism between the three groups(Table 1). Finally, we also noted increasing mean length of stays with frailty scores (LFR: 4.23 days, MFR: 7.12 days, and HFR: 10.42 days).

Discussion: Higher frailty scores were associated with greater risk of developing adverse effects and longer hospital stays but had a decreased risk of hemorrhage of the rectum/anus. Additional studies will help improve our understanding of the influence of frailty and bring forward adequate changes in care to decrease these complications.


Disclosures:


Lily Liu, BS¹, Renuka Verma, MD², Kyaw Min Tun, DO³, Hemamalini Sakthivel, MD⁴, Kamleshun Ramphul, MD⁵, Banreet Dhindsa, MD⁶. P3660 - A First Look Into Frailty’s Impact on Complications in Patients With Radiation Proctitis via the 2016-2020 National Inpatient Sample, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.