In-Hospital Mortality In Male Cancer Patients Undergoing Elective Percutaneous Coronary Interventions

Gad, Mohamed

Background
Percutaneous Coronary Interventions (PCI) have been increasingly performed electively in low risk patients with positive signs of ischemia on noninvasive tests. Cancer patients are a significant subset of the patients undergoing PCI and understanding disease outcome in such a patient population can further improve the survival following the procedure.

Methods
Nationwide Readmission Database (NRD) was accessed and data regarding patients undergoing PCI during hospitalization from January 2014 to December 2014 was obtained with the appropriate ICD codes and analyzed. Only male adult patients were included in the current study. Females, pediatric patients, and those admitted emergently were excluded. Odds ratio were used to estimate the risk of in-hospital mortality. All statistical tests were 2 sided.

Results
33,637 male patients underwent PCI in an elective admission. Mean age was 65.99 +/- 11.56 years. Following PCI, 509 (1.5%) of patients died during hospitalization. Out of the study cohort, 452 (1.34 %) patients had a solid tumor without metastasis and 136 (0.4 %) patients had metastatic cancer. Overall, the Odds Ratio (OR) of in-hospital mortality was elevated in patients without metastatic disease (OR) of 3.096 (95% confidence interval [CI]: 1.960 to 4.889), and patients with metastatic disease (OR) of 4.125 (95% CI: 2.008 to 8.472). However, once risk of in-hospital mortality was stratified by age. The risk became non-significant in patients younger than 75 years OR of 0.901 (95% CI 0.291: 2.791), and OR of 1.11 (95% CI: 0.354: 3.491) in non-metastatic disease and metastatic disease respectively. The risk was significantly increase in patients at the age of 75 or older; years OR of 3.325 (95% CI 1.987: 5.562), and OR of 6.929 (95% CI: 3.219: 14.915) in non-metastatic disease and metastatic disease respectively.

Conclusions
Male cancer patients have an increased risk of in-hospital mortality after undergoing PCI electively. The risk is mainly in the population aged 75 years of age and older. Interventionists should take the age of cancer patients into consideration when deciding the risk vs. benefit of PCI.