World J Oncol

World Journal of Oncology, ISSN 1920-4531 print, 1920-454X online, Open Access

Article copyright, the authors; Journal compilation copyright, World J Oncol and Elmer Press Inc

Journal website https://wjon.elmerpub.com

Original Article

Volume 16, Number 5, October 2025, pages 478-486

Predictors of All-Cause In-Hospital Mortality in Patients With Malignant Well-Differentiated Gastroenteropancreatic Neuroendocrine Tumors

**Table 1.** Sociodemographic Characteristics of Study Participants
	Total	Alive	Dead	P value
Variable distributions are presented as n (%) unless otherwise specified. M: mean; SD: standard deviation; DM: diabetes mellitus; GI: gastrointestinal; CCI: Charlson Comorbidity Index.
Age in years at admission, M (SD)	64.1 (12.9)	63.9 (12.9)	68.8 (11.3)	< 0.001
Sex				0.15
Male	2,896 (51.3%)	2,786 (51.1%)	110 (56.4%)
Female	2,742 (48.6%)	2,657 (48.8%)	85 (43.6%)
Race				0.70
White	3,949 (70.0%)	3,816 (70.1%)	133 (68.2%)
Black	852 (15.1%)	819 (15.0%)	33 (16.9%)
Hispanic	385 (6.8%)	374 (6.9%)	11 (5.6%)
Others	260 (4.6%)	249 (4.6%)	11 (5.6%)
Total charges, M (SD)	83,399.3 (154,359.6)	80,332.5 (148,188.5)	168,434.8 (261,623.0)	< 0.001
Median household income national quartile for patient ZIP code	0.47
1	1,384 (24.5%)	1,328 (24.4%)	56 (28.7%)
2	1,412 (25.0%)	1,367 (25.1%)	45 (23.1%)
3	1,355 (24.0%)	1,314 (24.1%)	41 (21.0%)
4	1,412 (25.0%)	1,362 (25.0%)	50 (25.6%)
Insurance				0.002
Private insurance	2,001 (35%)	1,956 (36%)	45 (23%)
Medicaid	428 (8%)	415 (8%)	13 (7%)
Medicare	2,993 (53%)	2,866 (53%)	127 (65%)
Others	217 (4%)	207 (4%)	10 (5%)
Obesity	822 (15%)	804 (15%)	18 (9%)	0.032
Tumor site				< 0.001
Small intestine	3,417 (61%)	3,327 (61%)	90 (46%)
Rectum	229 (4%)	223 (4%)	6 (3%)
Colon	580 (10%)	546 (10%)	34 (17%)
Stomach	503 (9%)	487 (9%)	16 (8%)
Pancreas	913 (16%)	864 (16%)	49 (25%)
Hyperlipidemia	1,561 (27.7%)	1,523 (28.0%)	38 (19.5%)	0.009
Lipid disorders	1,921 (34.0%)	1,874 (34.4%)	47 (24.1%)	0.003
Essential hypertension	2,478 (43.9%)	2,419 (44.4%)	59 (30.3%)	< 0.001
Type 2 DM with hyperglycemia	262 (4.6%)	254 (4.7%)	8 (4.1%)	0.71
Lower GI bleeding	146 (2.6%)	139 (2.6%)	7 (3.6%)	0.37
Protein energy malnutrition	879 (15.6%)	811 (14.9%)	68 (34.9%)	< 0.001
Systolic heart failure	143 (2.5%)	128 (2.3%)	15 (7.7%)	< 0.001
Iron deficiency anemia	232 (4.1%)	228 (4.2%)	4 (2.1%)	0.14
Elective versus non-elective admission	2,228 (39.6%)	2,200 (40.5%)	28 (14.4%)	< 0.001
Length of stay, M (SD)	6.7 (7.6)	6.6 (7.4)	10.0 (10.2)	< 0.001
Charleston Comorbidity Index (CCI)				< 0.001
CCI < 5	4,001 (70.9%)	3,896 (71.5%)	105 (53.8%)
CCI ≥ 5	1,641 (29.1%)	1,551 (28.5%)	90 (46.2%)
Admission year				0.90
2016	1,240 (22.0%)	1,198 (22.0%)	42 (21.5%)
2017	1,220 (21.6%)	1,182 (21.7%)	38 (19.5%)
2018	1,170 (20.7%)	1,126 (20.7%)	44 (22.6%)
2019	1,133 (20.1%)	1,095 (20.1%)	38 (19.5%)
2020	879 (15.6%)	846 (15.5%)	33 (16.9%)

Table 1. Sociodemographic Characteristics of Study Participants

Total

Alive

Dead

P value

N = 5,642

N = 5,447

N = 195

Variable distributions are presented as n (%) unless otherwise specified. M: mean; SD: standard deviation; DM: diabetes mellitus; GI: gastrointestinal; CCI: Charlson Comorbidity Index.

Age in years at admission, M (SD)

64.1 (12.9)

63.9 (12.9)

68.8 (11.3)

< 0.001

Sex

0.15

Male

2,896 (51.3%)

2,786 (51.1%)

110 (56.4%)

Female

2,742 (48.6%)

2,657 (48.8%)

85 (43.6%)

Race

0.70

White

3,949 (70.0%)

3,816 (70.1%)

133 (68.2%)

Black

852 (15.1%)

819 (15.0%)

33 (16.9%)

Hispanic

385 (6.8%)

374 (6.9%)

11 (5.6%)

Others

260 (4.6%)

249 (4.6%)

11 (5.6%)

Total charges, M (SD)

83,399.3 (154,359.6)

80,332.5 (148,188.5)

168,434.8 (261,623.0)

< 0.001

Median household income national quartile for patient ZIP code

0.47

1,384 (24.5%)

1,328 (24.4%)

56 (28.7%)

1,412 (25.0%)

1,367 (25.1%)

45 (23.1%)

1,355 (24.0%)

1,314 (24.1%)

41 (21.0%)

1,412 (25.0%)

1,362 (25.0%)

50 (25.6%)

Insurance

0.002

Private insurance

2,001 (35%)

1,956 (36%)

45 (23%)

Medicaid

428 (8%)

415 (8%)

13 (7%)

Medicare

2,993 (53%)

2,866 (53%)

127 (65%)

Others

217 (4%)

207 (4%)

10 (5%)

Obesity

822 (15%)

804 (15%)

18 (9%)

0.032

Tumor site

< 0.001

Small intestine

3,417 (61%)

3,327 (61%)

90 (46%)

Rectum

229 (4%)

223 (4%)

6 (3%)

Colon

580 (10%)

546 (10%)

34 (17%)

Stomach

503 (9%)

487 (9%)

16 (8%)

Pancreas

913 (16%)

864 (16%)

49 (25%)

Hyperlipidemia

1,561 (27.7%)

1,523 (28.0%)

38 (19.5%)

0.009

Lipid disorders

1,921 (34.0%)

1,874 (34.4%)

47 (24.1%)

0.003

Essential hypertension

2,478 (43.9%)

2,419 (44.4%)

59 (30.3%)

< 0.001

Type 2 DM with hyperglycemia

262 (4.6%)

254 (4.7%)

8 (4.1%)

0.71

Lower GI bleeding

146 (2.6%)

139 (2.6%)

7 (3.6%)

0.37

Protein energy malnutrition

879 (15.6%)

811 (14.9%)

68 (34.9%)

< 0.001

Systolic heart failure

143 (2.5%)

128 (2.3%)

15 (7.7%)

< 0.001

Iron deficiency anemia

232 (4.1%)

228 (4.2%)

4 (2.1%)

0.14

Elective versus non-elective admission

2,228 (39.6%)

2,200 (40.5%)

28 (14.4%)

< 0.001

Length of stay, M (SD)

6.7 (7.6)

6.6 (7.4)

10.0 (10.2)

< 0.001

Charleston Comorbidity Index (CCI)

< 0.001

CCI < 5

4,001 (70.9%)

3,896 (71.5%)

105 (53.8%)

CCI ≥ 5

1,641 (29.1%)

1,551 (28.5%)

90 (46.2%)

Admission year

0.90

2016

1,240 (22.0%)

1,198 (22.0%)

42 (21.5%)

2017

1,220 (21.6%)

1,182 (21.7%)

38 (19.5%)

2018

1,170 (20.7%)

1,126 (20.7%)

44 (22.6%)

2019

1,133 (20.1%)

1,095 (20.1%)

38 (19.5%)

2020

879 (15.6%)

846 (15.5%)

33 (16.9%)

**Table 2.** Factors Associated With Mortality Among Patients Admitted With GEP-NETs
	Odds ratio	P value	95% CI	Adjusted odds ratio	P value	95% CI
GEP-NETs: gastroenteropancreatic neuroendocrine tumors; CCI: Charlson Comorbidity Index.
Age	1.03	0	1.02	1.04	1.03	< 0.001	1.01	1.04
Sex
Male	Reference
Female	0.81	0.152	0.61	1.08	0.80	0.158	0.59	1.09
Race
White	Reference
Black	1.16	0.464	0.78	1.71	1.08	0.732	0.70	1.68
Hispanic	0.84	0.594	0.45	1.58	0.73	0.378	0.37	1.46
Others	1.27	0.46	0.68	2.38	1.26	0.516	0.63	2.51
Median household income national quartile for patient ZIP code
1	Reference
2	0.78	0.225	0.52	1.16	0.86	0.497	0.55	1.33
3	0.74	0.15	0.49	1.12	0.81	0.348	0.51	1.26
4	0.87	0.485	0.59	1.28	0.87	0.548	0.56	1.36
Insurance type
Private	Reference
Medicaid	1.36	0.334	0.73	2.55	1.11	0.787	0.53	2.33
Medicare	1.93	< 0.001	1.36	2.72	1.03	0.881	0.68	1.56
Others	2.10	0.038	1.04	4.23	1.83	0.123	0.85	3.93
Admission type
Non-elective	Reference
Elective	0.25	< 0.001	0.17	0.37	0.40	< 0.001	0.25	0.63
Total charges	1.00	1.32	0.19	1.00	1.00	0.339	1.00	1.00
Tumor site
Small intestine	Reference
Rectum	0.99	0.99	0.43	2.30	0.75	0.557	0.29	1.94
Colon	2.30	< 0.001	1.54	3.45	2.31	< 0.001	1.51	3.53
Stomach	1.21	0.481	0.71	2.08	1.06	0.857	0.58	1.93
Pancreas	2.10	< 0.001	1.47	2.99	1.52	0.047	1.01	2.30
Length of stay	1.03	0.056	1.00	1.06	1.01	0.279	0.99	1.03
Charleston Comorbidity Index
CCI < 5	Reference
CCI ≥ 5	2.15	< 0.001	1.61	2.87	1.49	0.023	1.06	2.10
Obesity	0.59	0.033	0.36	0.96	0.93	0.804	0.54	1.62
Essential hypertension	0.54	< 0.001	0.40	0.74	0.65	0.013	0.47	0.91
Hyperlipidemia	0.62	0.010	0.44	0.89	0.85	0.677	0.40	1.81
Lipid disorders	0.61	0.003	0.43	0.84	0.64	0.218	0.32	1.30
Protein energy malnutrition	3.06	< 0.001	2.26	4.15	1.84	0.001	1.29	2.62
Systolic heart failure	3.46	< 0.001	1.99	6.03	2.09	0.024	1.10	3.95
Iron deficiency anemia	0.48	0.149	0.18	1.30	0.42	0.094	0.15	1.16

Table 2. Factors Associated With Mortality Among Patients Admitted With GEP-NETs

Odds ratio

P value

95% CI

Adjusted odds ratio

P value

95% CI

GEP-NETs: gastroenteropancreatic neuroendocrine tumors; CCI: Charlson Comorbidity Index.

Age

1.03

1.02

1.04

1.03

< 0.001

1.01

1.04

Sex

Male

Reference

Female

0.81

0.152

0.61

1.08

0.80

0.158

0.59

1.09

Race

White

Reference

Black

1.16

0.464

0.78

1.71

1.08

0.732

0.70

1.68

Hispanic

0.84

0.594

0.45

1.58

0.73

0.378

0.37

1.46

Others

1.27

0.46

0.68

2.38

1.26

0.516

0.63

2.51

Median household income national quartile for patient ZIP code

Reference

0.78

0.225

0.52

1.16

0.86

0.497

0.55

1.33

0.74

0.15

0.49

1.12

0.81

0.348

0.51

1.26

0.87

0.485

0.59

1.28

0.87

0.548

0.56

1.36

Insurance type

Private

Reference

Medicaid

1.36

0.334

0.73

2.55

1.11

0.787

0.53

2.33

Medicare

1.93

< 0.001

1.36

2.72

1.03

0.881

0.68

1.56

Others

2.10

0.038

1.04

4.23

1.83

0.123

0.85

3.93

Admission type

Non-elective

Reference

Elective

0.25

< 0.001

0.17

0.37

0.40

< 0.001

0.25

0.63

Total charges

1.00

1.32

0.19

1.00

0.339

1.00

Tumor site

Small intestine

Reference

Rectum

0.99

0.43

2.30

0.75

0.557

0.29

1.94

Colon

2.30

< 0.001

1.54

3.45

2.31

< 0.001

1.51

3.53

Stomach

1.21

0.481

0.71

2.08

1.06

0.857

0.58

1.93

Pancreas

2.10

< 0.001

1.47

2.99

1.52

0.047

1.01

2.30

Length of stay

1.03

0.056

1.00

1.06

1.01

0.279

0.99

1.03

Charleston Comorbidity Index

CCI < 5

Reference

CCI ≥ 5

2.15

< 0.001

1.61

2.87

1.49

0.023

1.06

2.10

Obesity

0.59

0.033

0.36

0.96

0.93

0.804

0.54

1.62

Essential hypertension

0.54

< 0.001

0.40

0.74

0.65

0.013

0.47

0.91

Hyperlipidemia

0.62

0.010

0.44

0.89

0.85

0.677

0.40

1.81

Lipid disorders

0.61

0.003

0.43

0.84

0.64

0.218

0.32

1.30

Protein energy malnutrition

3.06

< 0.001

2.26

4.15

1.84

0.001

1.29

2.62

Systolic heart failure

3.46

< 0.001

1.99

6.03

2.09

0.024

1.10

3.95

Iron deficiency anemia

0.48

0.149

0.18

1.30

0.42

0.094

0.15

1.16