RPD109 - Inpatient Palliative Care and Reduced 30-Day Readmissions in Metastatic Colorectal Cancer: A Nationwide Analysis

Key Message : Inpatient encounters for palliative care among patients with metastatic colorectal cancer are associated with reduced 30-day readmissions, emphasizing its role in improving care and promoting efficient use of hospital resources.

Abstract: Background
Colorectal cancer is the fourth most commonly diagnosed cancer and the second leading cause of cancer-related death in the United States, with rising incidence among younger adults [1,2]. Metastatic colorectal cancer (mCRC) carries a high symptom burden, frequent hospitalizations, and complex transitions of care that contribute to fragmented management and diminished quality of life. While inpatient palliative care (PC) improves symptom control and care alignment, its impact on national readmission outcomes remains underexplored. This study examines the association between inpatient encounters for PC and 30-day readmissions among patients with mCRC across the US.

Methods
Using the 2017–2021 Nationwide Readmissions Database (NRD), adult patients hospitalized with mCRC who survived to discharge were identified. NRD discharge weights were applied to generate nationally representative estimates. Multivariable survey-weighted logistic regression assessed the association between inpatient PC and 30-day readmission, adjusting for demographics, comorbidities, and hospital characteristics.

Results
Among 55,975 weighted hospitalizations for mCRC, 16.11% included a PC encounter. The overall 30-day readmission rate was 15.22%, and inpatient mortality was 10.23%. PC recipients were more likely to be older (mean difference 3.6 years, p< 0.01), male (p < 0.01), Medicare-insured (p < 0.01), and hospitalized at urban teaching facilities (p < 0.01). Inpatient PC was independently associated with lower odds of 30-day readmission (aOR 0.57, 95% CI 0.52–0.63, p< 0.01).

Conclusion
In this nationwide analysis, inpatient palliative care was associated with significantly reduced 30-day readmissions among patients with metastatic colorectal cancer. These findings underscore PC as a critical component of high-quality oncology care, supporting its integration into inpatient settings to enhance care continuity, reduce avoidable readmissions, and improve overall care quality.

References: 1. Neuberger E, Schwartz N, Hsu L, Dillon A, Siadak M. Burden of illness in metastatic colorectal cancer. Journal of Clinical Oncology, 2023. DOI:10.1200/JCO.2023.41.4_suppl.53.

2. Tahir M, Tahir Z, Zaheer A, et al. Outcomes of Lower Gastrointestinal Bleeding Among Colorectal Cancers Patients: An Analysis from Nationwide Readmissions Database. The American Journal of Gastroenterology, 2023. DOI: 10.14309/01.ajg.0000952800.32292.1e.