Effects of Malnutrition on In-Hospital and Discharge Outcomes Among Young Adults Hospitalized with Gastrointestinal Cancers: National Estimates from the United States.

Manas Pustake, Lakshmi Kattamuri, Shubhangi Deoker, Kunal Sharma, Abhizith Deoker

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Article in Journal of gastrointestinal cancer, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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5 authors.

Manas PustakeDepartment of Internal Medicine, Texas Tech University Health Sciences Center El Paso, 130 Rick Francis St, El Paso, TX, 79905, USA. pustakemanas@gmail.com.

Lakshmi KattamuriDepartment of Internal Medicine, Texas Tech University Health Sciences Center El Paso, 130 Rick Francis St, El Paso, TX, 79905, USA.

Shubhangi DeokerDepartment of Internal Medicine, Texas Tech University Health Sciences Center El Paso, 130 Rick Francis St, El Paso, TX, 79905, USA.

Kunal SharmaDepartment of Internal Medicine, Texas Tech University Health Sciences Center El Paso, 130 Rick Francis St, El Paso, TX, 79905, USA.

Abhizith DeokerDepartment of Internal Medicine, Texas Tech University Health Sciences Center El Paso, 130 Rick Francis St, El Paso, TX, 79905, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeProtein-energy malnutrition (PEM) is common in gastrointestinal (GI) cancers and may worsen inpatient outcomes. Contemporary national data describing the impact of PEM among young adults with GI malignancies are limited.

methodsWe conducted a retrospective cohort study using HCUP NIS data from 2018 to 2021. We identified hospitalizations of adults aged 18 to 39 years with GI cancers using ICD 10 CM codes C15 to C26. We defined PEM using ICD-10-CM diagnosis codes recorded during the index hospitalization; therefore, PEM reflects clinically documented/coded malnutrition rather than the full burden of nutritional risk or clinically undiagnosed malnutrition. Primary outcomes were in hospital mortality and discharge disposition. Secondary outcomes were LOS and total hospital charges. We used survey weighted multivariable logistic and linear regression to estimate adjusted associations, accounting for age, sex, race or ethnicity, payer, income quartile, admission type, calendar year, and age adjusted CCI.

resultsAmong 58,910 weighted hospitalizations of young adults with gastrointestinal cancers, 11,915 (20.2%) had protein-energy malnutrition (PEM). Compared with those without PEM, hospitalizations with PEM had a higher burden of advanced disease and acute illness, including a greater prevalence of metastatic disease (71.8% vs. 53.1%), and experienced worse unadjusted outcomes, including higher in-hospital mortality (8.4% vs. 3.2%), longer length of stay (10.43 vs. 5.63 days), and higher total hospital charges ($133,790 vs. $83,702). In adjusted analyses, PEM was independently associated with increased odds of in-hospital mortality (aOR 2.13, 95% CI 1.72-2.56; p < 0.001) and higher odds of non-home discharge (aOR 1.67, 95% CI 1.47-1.89; p < 0.001). PEM was also associated with substantially greater resource utilization, including an adjusted increase of 4.49 hospital days (β + 4.492; SE 0.248; p < 0.001) and $53,513 higher total hospital charges (β +$53,512.6; SE $5,527.6; p < 0.001).

conclusionPEM affected one in five hospitalizations among young adults with GI cancers and was independently associated with increased mortality, non-home discharge, LOS, and hospital charges. These findings support routine inpatient nutritional assessment and early intervention in this high risk population.

Indexed as

Gastrointestinal NeoplasmsHospitalizationPatient DischargeProtein-Energy MalnutritionAdolescentAdultFemaleHospital ChargesHospital MortalityHumansLength of StayMalePrevalenceRetrospective StudiesUnited StatesYoung AdultCancer outcomesDischarge dispositionGastrointestinal cancersHealth care utilizationHospital chargesIn hospital mortalityLength of stayNational inpatient sampleProtein energy malnutritionYoung adults

Identifiers

PMID42507223

DOI10.1007/s12029-026-01525-8

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