P6319 - Ascites in Gastric Cancer Hospitalizations: Insights From the Nationwide Inpatient Sample

Ibrahim Shanti, MD¹, Malik Samardali, MD², Abdul Muhsen Abdeen, MD², Wesam Frandah, MD³, Ahmed Sherif, MD³
1Marshall University - - Huntington, WV, Huntington, WV; 2Joan C. Edwards School of Medicine, Marshall University, Huntington, WV; 3Marshall University Joan C. Edwards School of Medicine, Huntington, WV

Introduction: Ascites is a frequent complication in cancer patients, contributing to significant morbidity. Stomach cancer, particularly in advanced stages, is associated with an increased risk of ascites. However, its effect on inpatient outcomes, mortality, and healthcare costs remains unclear. Given the limited literature, understanding how ascites influences clinical and economic outcomes in hospitalized stomach cancer patients is crucial for improving management strategies.

Methods: This retrospective cohort study used the 2019 National Inpatient Sample (NIS) to identify adult patients hospitalized with stomach cancer using ICD-10 codes. Patients were categorized into two cohorts: those with concurrent ascites and those without. Primary outcome: all-cause in-hospital mortality. Secondary outcomes: pulmonary embolism, septic shock, gastrointestinal hemorrhage, and hospitalization costs. Multivariate logistic regression models were used to adjust for age, sex, comorbidities, and other confounders. Statistical significance was set at p < 0.05.

Results: Of 32,695 stomach cancer hospitalizations, 6,455 (19.7%) had concurrent ascites. These patients were older (mean age 66.5 vs. 65.7 years) and predominantly male (74.4%). Surprisingly, ascites was not significantly associated with:

• In-hospital mortality (adjusted odds ratio [aOR] 1.05, 95% CI 0.83–1.31, p = 0.66).


• Pulmonary embolism (aOR 0.79, 95% CI 0.54–1.14, p = 0.2).


• Septic shock (aOR 1.09, 95% CI 0.82–1.46, p = 0.5).

Unexpectedly, ascites was associated with a lower incidence of gastrointestinal hemorrhage (aOR 0.64, 95% CI 0.51–0.80, p < 0.001) and lower hospitalization costs ($75,169 vs. $79,069; p < 0.001).

Discussion: Ascites in stomach cancer patients was not associated with increased mortality, pulmonary embolism, or septic shock but was linked to lower rates of gastrointestinal hemorrhage and hospitalization costs. These findings challenge conventional assumptions and suggest that further research is needed to understand the clinical significance of ascites in this population.

Disclosures:
Ibrahim Shanti indicated no relevant financial relationships.
Malik Samardali indicated no relevant financial relationships.
Abdul Muhsen Abdeen indicated no relevant financial relationships.
Wesam Frandah: Boston Scientific – Advisor or Review Panel Member, Consultant. Merritt – Consultant. Olympus corporation of America – Consultant.
Ahmed Sherif indicated no relevant financial relationships.

Ibrahim Shanti, MD¹, Malik Samardali, MD², Abdul Muhsen Abdeen, MD², Wesam Frandah, MD³, Ahmed Sherif, MD³. P6319 - Ascites in Gastric Cancer Hospitalizations: Insights From the Nationwide Inpatient Sample, ACG 2025 Annual Scientific Meeting Abstracts. Phoenix, AZ: American College of Gastroenterology.