Association between Gastroparesis and the Pancreatic Cancer Risk and In-Hospital Mortality: A Nationwide Analysis from the United States

Background/Aims: Pancreatic cancer is a highly lethal malignancy often diagnosed at an advanced stage. Gastroparesis, marked by delayed gastric emptying, may be a potential risk factor or early indicator. Despite this, little is known about the association between gastroparesis and pancreatic cancer. Methods: This retrospective cohort study analyzed the data from the Nationwide Inpatient Sample (2016-2021), encompassing 207,629,866 hospitalizations. Adult hospitalizations with a diagnosis of pancreatic cancer, and with or without a diagnosis of gastroparesis, were identified using International Classification of Diseases, Tenth Revision codes. Multivariable logistic regression was used to assess the association between gastroparesis and pancreatic cancer, adjusting for demographic and clinical variables. Results: Among 603,075 hospitalizations of patients with pancreatic cancer, 6,095 (1.0%) had gastroparesis compared to 0.7% of the hospitalizations with non-pancreatic cancer patients (p<0.001). Among the pancreatic cancer patients, those with gastroparesis were younger (mean age 65.55±11.61 vs. 68.46±11.44 years; p<0.001) and more likely to be female (54.2% vs. 45.8%; p<0.001). Patients with gastroparesis experienced longer hospital stays (8.48±8.30 days vs. 5.70±5.70 days; p<0.001) and higher total charges ($86,385.90±$105,352.67 vs. $63,250.12±$78,421.65; p<0.001). Gastroparesis was linked to an increased odds of pancreatic cancer (odds ratio [OR] 1.12, 95% confidence interval [CI] 1.08-1.16) and reduced in-hospital mortality (OR 0.51, 95% CI 0.44-0.58; p<0.001). Conclusions: Gastroparesis is associated with higher odds of pancreatic cancer but a lower risk of in-hospital mortality from pancreatic cancer hospitalizations. Although causal and temporal relationships cannot be established because of the cross-sectional nature of the dataset.