Predictors of in-Hospital Mortality in Chemotherapy-Associated Cardiomyopathy: A National Inpatient Sample Analysis (2018-2022)

Document Type

Conference Proceeding

Publication Date

5-27-2026

Publication Title

J Clin Oncol

Keywords

adult, age, alcoholism, blood clotting disorder, body weight loss, cardiomyopathy, cohort analysis, complication, conference abstract, controlled study, diabetes mellitus, electrolyte disturbance, female, high risk patient, hospitalization, human, hypertension, ICD-10, liver disease, major clinical study, male, metastasis, mortality, Munchausen syndrome, peripartum cardiomyopathy, predictive model, receiver operating characteristic, retrospective study

Abstract

Background: Chemotherapy-associated cardiomyopathy (CAC) is a recognized complication of cancer treatment, yet predictors of in-hospital mortality remain poorly characterized at the national level. We aimed to identify baseline clinical factors associated with mortality in hospitalized CAC patients. Methods: We conducted a retrospective cohort study using the National Inpatient Sample (2018-2022). Adults with cardiomyopathy (ICD-10: I420, I427, I428, I429) and chemotherapy exposure or cancer history (Z5111, Z5112, Z85) were included. Patients with ischemic, hypertensive, alcoholic, or postpartum cardiomyopathy were excluded. Survey-weighted multivariate logistic regression identified independent predictors of in-hospital mortality. Model discrimination was assessed using area under the receiver operating characteristic curve (AUC). Results: We identified 14, 896 hospitalizations (weighted national estimate: 74, 480). Mean age was 70.7 years and in-hospital mortality was 0.74% (n = 110). On multivariate analysis, independent predictors of mortality included metastatic cancer (aOR 4.01, 95% CI 2.31-6.96, p < 0.001), weight loss (aOR 3.74, 95% CI 2.28-6.14, p < 0.001), renal disease (aOR 2.51, 95% CI 1.67-3.76, p < 0.001), liver disease (aOR 2.26, 95% CI 1.12-4.56, p = 0.024), and increasing age (aOR 1.04 per year, 95% CI 1.02-1.07, p < 0.001). Female sex, coagulopathy, fluid/electrolyte disorders, complicated diabetes, and hypertension were not significantly associated with mortality. The prediction model demonstrated fair discrimination (AUC 0.746, 95% CI 0.700-0.792). Conclusions: In this nationally representative analysis of CAC hospitalizations, metastatic cancer, weight loss, renal disease, liver disease, and older age were independent predictors of in-hospital mortality. These findings may help identify high-risk patients requiring closer monitoring during hospitalization.

Volume

44

Issue

16_Suppl

First Page

e24025

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