Impact of Pressure-Related Injury on Hospitalized Patients With Colorectal Cancer: A United States Population-Based Cohort Study

Document Type

Conference Proceeding

Publication Date

6-1-2025

Publication Title

Journal of Clinical Oncology

Abstract

Background: Colorectal cancer is the third most common cancer worldwide. Newer treatment options have significantly helped improve quality of life, albeit with the potential for more adverse effects. Pressure-related injuries, including pressure ulcers, sacral wounds, heel ulcers, and full-thickness wounds, continue to be significant comorbidity in hospitalized patients. Patients with underlying malignancy are more prone to developing pressure-related injury, especially in cases with poor performance status. Our study aims to explore the impact of pressure-related injury on hospitalized patients with colorectal cancer. Methods: We utilized the 2020 National Inpatient Sample (NIS) Database in conducting this retrospective cohort study. We identified patients with colorectal cancer and pressure-related injury using appropriate ICD-10 diagnostic codes. We stratified patients with colorectal cancer based on the presence or absence of pressure-related injury. A survey multivariable logistic and linear regression analysis was used to calculate adjusted odds ratios (ORs) for the primary and secondary outcomes. A p value of < 0.05 was considered statistically significant. Results: We identified a total of 77130 hospitalized patients with colorectal cancer, of which 0.26% (205/77130) had comorbid pressure-related injury. The overall in-hospital mortality among patients with colorectal cancer was 2.74% (2115/77130). Among those with concomitant pressure-related injury, the mortality rate was significantly higher at 12.20% (25/205, p< 0.001). Utilizing a stepwise survey multivariable logistic regression model that adjusted for patient and hospital level confounders, pressure-related injury was found to be an independent predictor of increased in-hospital mortality (adjusted OR 3.22; 95% (confidence interval [CI] 1.22-8.51; p= 0.018), longer LOS (coefficient 7.41 days; CI 2.15-12.66; p= 0.006), but not higher total hospitalization charge ($25963; CI -$4867-$56794; p=0.099) or increased need for mechanical ventilation (adjusted OR 3.27; CI 0.95-11.23; p= 0.059). Conclusions: Our analysis demonstrated that pressure-related injury was prevalent in hospitalized patients with colorectal cancer. It was associated with significantly worsened in-hospital mortality and longer LOS. Efforts should be made for early diagnosis and accurate documentation of pressure-related injuries. Strategies focused on establishing institutional protocols for preventing and managing pressure-related injuries, including wound care teams as indicated, may help improve clinical outcomes. Further prospective studies are needed to describe these associations better.

Volume

43

Issue

16 Suppl

First Page

e15688

Comments

2025 ASCO (American Society of Clinical Oncology) Annual Meeting, May 30 - June 3, 2025, Chicago, IL

Last Page

e15688

DOI

10.1200/JCO.2025.43.16_suppl.e15688

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