Frontiers in Endocrinology (Oct 2023)

The short- and long-term readmission of four major categories of digestive system cancers: does obesity or metabolic disorder matter?

  • Yan Li,
  • Yan Li,
  • Yan Li,
  • Yan Li,
  • Yan Li,
  • Xiaoqin Wu,
  • Yongfeng Song,
  • Yongfeng Song,
  • Yongfeng Song,
  • Yongfeng Song,
  • Yongfeng Song,
  • Yongfeng Song,
  • Peipei Wang,
  • Bofei Zhang,
  • Bingzhou Guo,
  • Ziwei Liu,
  • Yafei Wu,
  • Yafei Wu,
  • Yafei Wu,
  • Yafei Wu,
  • Yafei Wu,
  • Yafei Wu,
  • Shanshan Shao,
  • Shanshan Shao,
  • Shanshan Shao,
  • Shanshan Shao,
  • Shanshan Shao,
  • Shanshan Shao,
  • Yiping Cheng,
  • Yiping Cheng,
  • Yiping Cheng,
  • Yiping Cheng,
  • Yiping Cheng,
  • Yiping Cheng,
  • Honglin Guo,
  • Honglin Guo,
  • Honglin Guo,
  • Honglin Guo,
  • Honglin Guo,
  • Honglin Guo,
  • Xiude Fan,
  • Xiude Fan,
  • Xiude Fan,
  • Xiude Fan,
  • Xiude Fan,
  • Xiude Fan,
  • Jiajun Zhao,
  • Jiajun Zhao,
  • Jiajun Zhao,
  • Jiajun Zhao,
  • Jiajun Zhao,
  • Jiajun Zhao

DOI
https://doi.org/10.3389/fendo.2023.1214651
Journal volume & issue
Vol. 14

Abstract

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PurposePatients with digestive system cancers (DSCs) are at a high risk for hospitalizations; however, the risk factors for readmission remain unknown. Here, we established a retrospective cohort study to assess the association between metabolic obesity phenotypes and readmission risks of DSC.Experimental designA total of 142,753 and 74,566 patients at index hospitalization were ultimately selected from the Nationwide Readmissions Database (NRD) 2018 to establish the 30-day and 180-day readmission cohorts, respectively. The study population was classified into four groups: metabolically healthy non-obese (MHNO), metabolically healthy obese (MHO), metabolically unhealthy non-obese (MUNO), and metabolically unhealthy obese (MUO). Multivariate Cox regression analysis was used to estimate the effect of metabolic obesity phenotypes on DSC readmission.ResultsThe MUNO phenotype had 1.147-fold (95% CI: 1.066, 1.235; p < 0.001) increased 180-day readmission risks in patients with neoplasm of the upper digestive tract. The MUNO phenotype had 1.073-fold (95% CI: 1.027, 1.121; p = 0.002) increased 30-day readmission risks and 1.067-fold (95% CI: 1.021, 1.115; p = 0.004) increased 180-day readmission risks in patients with neoplasm of the lower digestive tract. The MUNO and MUO phenotypes were independent risk factors of readmission in patients with liver or pancreatic neoplasm. Metabolic obesity status was independently associated with a high risk of severe and unplanned hospitalization within 30 days or 180 days.ConclusionBoth obesity and metabolic abnormalities are associated with a high risk for the poor prognosis of DSC patients. The effect of metabolic categories on the short- or long-term readmission of liver or pancreas cancers may be stronger than that of obesity.

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