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

Abstract

Background: Factors influencing in-hospital mortality in patients with well-differentiated gastroenteropancreatic neuroendocrine tumors (GEP-NETs) remain understudied, highlighting gaps in optimizing acute clinical outcomes. This study aimed to identify sociodemographic and clinical predictors of all-cause in-hospital mortality in this population.

Methods: Using 2016 - 2020 data from the National Inpatient Sample (NIS), patients with malignant well-differentiated GEP-NETs were identified via the International Classification of Diseases, 10th Revision (ICD-10) codes. The primary outcome was in-hospital mortality. Sociodemographic and clinical variables (heart failure (HF), malnutrition, Charlson Comorbidity Index (CCI), and tumor site) were analyzed using multivariable logistic regression.

Results: Among 5,642 patients (mean age 64, standard deviation (SD) 12.9), multivariable analysis identified HF (adjusted odds ratio (aOR) 2.09, 95% confidence interval (CI): 1.10 - 3.95), malnutrition (aOR 1.84, 95% CI: 1.29 - 2.62), pancreatic (aOR 1.52, 95% CI: 1.01 - 2.30) or colon tumors (aOR 2.31, 95% CI: 1.51 - 3.53), CCI ≥ 5 (aOR 1.49, 95% CI: 1.06 - 2.10), hypertension (aOR 0.65, 95% CI: 0.47 - 0.91) and elective admissions (aOR 0.40, 95% CI: 0.25 - 0.63) as clinically relevant factors associated with in-hospital mortality.

Conclusions: Advanced age, tumor location, malnutrition, and HF may be critical mortality predictors among patients with GEP-NETs. These findings advocate for integrated care models prioritizing nutritional support, cardiovascular monitoring, and early elective interventions to improve outcomes.