Characteristics, management, and outcomes among admissions for primary cardiac tumors: Results from the National Inpatient Sample

Abstract

Introduction: Primary cardiac tumors (PCT) are rare, and their contemporary outcomes are not well characterized in the literature. We assessed temporal trends in patient characteristics and management of admissions for PCT in US hospitals. Methods: Admissions with the principal diagnoses of a PCT (benign neoplasm of heart: ICD-9 212.7, ICD-10 D15.1; malignant neoplasm of heart: ICD-9 164.1, ICD-10 C38.0) between 2006 and 2017 were extracted from the National Inpatient Sample. Trends in demographics and clinical profiles were evaluated. We conducted descriptive analyses on the cohort and compared outcomes between those managed medically and surgically.Results: Between 2006 and 2017, 19,111 admissions had the primary diagnosis of a PCT. Of these, 91.1% were benign. Admissions were mostly female (65.0%), caucasian (72.0%), and aged more than 50 years (76.0%). The annual admission rate for PCT was similar from 2006 to 2017 (p trend > .05) and associated with congestive heart failure, diabetes, renal failure, and valvular lesions. PCTs were managed surgically in 12,811 (67.0%) of overall cases, 70.8% for benign and 28.3% for malignant tumors. Overall, the in-hospital mortality rate was 2.3%. Medically managed cases reported a 2.5% higher mortality (p < .001) than those surgically managed. Admissions with malignant tumors were more likely to expire during hospitalization than those with benign tumors (odds ratio, 9.75; 95% confidence interval 6.34-14.99; p < .001). Conclusion:Admissions for primary cardiac tumors were primarily women or in their fifth or sixth decade of life. Surgical intervention is more commonly practiced and is associated with better in-hospital survival.

Surgery for Primary Cardiac Tumors in Children: Successful Management of Large Fibromas

“…The longitudinal European multicenter study reported early mortality of 4.5% in 89 children ( 10 ). The National Inhospital Sample database in the United States recorded 186 (1.5%) in-hospital mortalities among 12,811 cases of surgically managed PCT ( 17 ). Few studies have reported long-term outcomes following PCT resection, especially in pediatrics.…”

Racial and ethnic characteristics and cancer-specific survival in Primary Malignant Cardiac Tumors

“…A relative increase in the utilization of population-based databases to study sociodemographic features of PMCTs has been seen in recent years ( 11 , 12 ). A study conducted by Heaton et al on the National Inpatient Sample showed higher in-hospital mortality in Hispanic patients as compared to Whites in a multivariable analysis ( p = 0.03) ( 13 ). Oliveira et al compared incidences of cardiac and non-cardiac tumors in White, Black, and “Other” races in SEER and found a significantly higher incidence of mesotheliomas of cardiac origin in the Black population (15.9 vs. 4.9%) ( 1 ).…”

Practical characteristics of the patients with primary cardiac tumors

“…In patients with a medical group, probably not all patients received chemotherapy. 1 It might be informative to stratify the medical group into those with and without chemotherapy to investigate the outcomes of chemotherapy.…”

“…The authors reported that the existence of atrial fibrillation was associated with undergoing the surgery. 1 Atrial fibrillation is in general associated with high age and comorbidity such as heart failure, hypertension, and diabetes mellitus, all of which would be surgical high-risk factors. Could the authors explain the mechanism why those with atrial fibrillation tended to receive surgery?…”

“…To the Editor, Primary cardiac tumors are rare and their contemporary characteristics remain unclear. Heaton et al 1 summarized characteristics of over 10,000 patients with a primary diagnosis of primary cardiac tumors. They found that surgical intervention was more commonly practiced and was associated with better in-hospital mortality compared with medical therapy.…”