AUTHOR=Li Yan , Wu Xiaoqin , Song Yongfeng , Wang Peipei , Zhang Bofei , Guo Bingzhou , Liu Ziwei , Wu Yafei , Shao Shanshan , Cheng Yiping , Guo Honglin , Fan Xiude , Zhao Jiajun 

TITLE=The short- and long-term readmission of four major categories of digestive system cancers: does obesity or metabolic disorder matter?

JOURNAL=Frontiers in Endocrinology

VOLUME=Volume 14 - 2023

YEAR=2023

URL=https://www.frontiersin.org/journals/endocrinology/articles/10.3389/fendo.2023.1214651

DOI=10.3389/fendo.2023.1214651

ISSN=1664-2392

ABSTRACT=Purpose: Patients with digestive system cancers (DSC) are at high risk for hospitalizations, however, risk factors for readmission remain unknown. Here, we established a retrospective cohort study to assess the association between metabolic obesity phenotypes and readmission risks of DSC.
Experimental Design: A total of 142,753 and 74,566 patients at index hospitalization were ultimately selected from the Nationwide Readmissions Database (NRD) 2018 to establish 30-day and 180-day readmission cohort, respectively. The study population was classified into four groups: metabolically healthy non-obese (MHNO), metabolically healthy obese (MHO), metabolically unhealthy non-obese (MUNO) and metabolically unhealthy obese (MUO). The multivariate Cox regression analysis was used to estimate the effect of metabolic obesity phenotypes on DSC readmission. 
Results: The MUNO phenotype had 1.147-fold [95% CI: 1.066,1.235;p<0.001) increased 180-day readmission risks in patients with neoplasm of upper digestive tract. MUNO phenotype had 1.073-fold [95% CI: 1.027,1.121;p=0.002] increased 30-day readmission risks and 1.067-fold [95% CI: 1.021,1.115,;p=0.004] increased 180-day readmission risks in patients with neoplasm of lower digestive tract. MUNO and MUO phenotypes were independent risk factors of readmission in patients with liver or pancreatic neoplasm. Metabolic obesity status was independently associated with a high risk of severe and unplanned hospitalization within 30 or 180 days. 
Conclusions: Both obesity and metabolic abnormities are associated with a high risk for the poor prognosis of DSC patients. The effect of metabolic categories on the short- or long-term readmission of liver or pancreas cancers may be stronger than that of obesity.