Association of congestive heart failure with hospital outcomes among renal cancer patients in the United States: analysis of nationwide inpatient sample

ABSTRACT

Background: Patients with renal cancer are at increased risk of comorbid congestive heart failure (CHF) due to several shared risk factors and the cardiotoxicity of some medications used for renal cancer treatment. We aimed to examine the relationship between CHF and hospital outcomes among renal cancer patients in the U.S.

Methods: In this cross-sectional study, we identified hospitalizations of renal cancer patients using the 2015–2017 National Inpatient Sample. We assessed the relationship between CHF and hospital outcomes in this patient population, including in-hospital mortality, length-of-stay (LoS), and hospital costs.

Results: Among the 20,321 hospitalizations of renal cancer patients identified, 6.1% involved patients with comorbid CHF (n = 1,231). The odds of in-hospital mortality did not differ based on CHF presence (odds ratio = 1.21; p = 0.354). Hospitalizations of renal cancer patients with CHF were associated with a greater LoS (incidence rate ratio = 1.44; p < 0.001) and higher hospital costs (cost ratio = 1.27; p < 0.001) than those without CHF.

Conclusions: CHF in renal cancer patients is associated with increased LoS and higher hospital costs. These findings suggest that optimal management of comorbid CHF may improve hospital outcomes in patients with renal cancer and provides evidence to support the emerging field of cardio-oncology.

KEYWORDS:

• Renal cancer
• congestive heart failure
• in-hospital mortality
• hospital utilization
• hospital costs

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewers disclosure

Peer reviewers on this manuscript have no relevant financial relationships or otherwise to disclose.

Author contributions

All authors were involved in the data interpretation and revising the manuscript. CP and SP were involved in the conception and design, statistical analyses, and drafting of the paper. CP and JH provided essential advice on the focus of the analysis and methodology. LP, CS, JH, and CP revised this manuscript for intellectual content. All authors jointly made the decision to submit the manuscript for publication.

Supplementary material

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Additional information

Funding

This paper was not funded.