The association of cardiovascular comorbidities with malignant and benign colorectal neoplasms.

The study identified a large national sample of primary lower GI bleed admissions, about a third of which involved cardiovascular comorbidities.

• 802,080 primary lower GI bleed admissions (ICD-9) were identified in the 2007-2011 National Inpatient Sample (NIS).
• 283,925 of these admissions had cardiovascular comorbidities.
• The primary outcome was a new diagnosis of benign or malignant colorectal neoplasms.

Patients with lower GI bleeding who had no cardiovascular comorbidities had substantially higher odds of malignant colorectal neoplasm than those with cardiovascular comorbidities.

• Between 2007 and 2011, the odds of malignant colorectal neoplasms were 49.9% to 65.3% higher for patients without cardiovascular comorbidities.
• The comparison group was patients with cardiovascular comorbidities presenting with a lower GI bleed.
• The authors conclude patients without cardiovascular comorbidities were significantly more likely to be diagnosed with malignant colorectal neoplasms.

Patients with cardiovascular comorbidities had higher odds of a benign colorectal neoplasm diagnosis only in one year, 2010.

• In 2010, patients with cardiovascular comorbidities had 10.5% higher odds of benign colorectal neoplasms than those without.
• This was described as the most notable and statistically significant difference for benign neoplasms across 2007-2011.
• Other years did not show a comparably significant difference per the abstract.

The analysis used weighted survey methods with trend tests and multinomial regression for cancer stage.

• Weighted analyses accounting for the complex survey design were performed in SAS 9.4.
• Trends were assessed using Cochran-Armitage tests and linear regression.
• Associations with colorectal cancer stage were evaluated by multinomial logistic regression, with significance at p ≤ 0.05.