Gastroenterol Res

Gastroenterology Research, ISSN 1918-2805 print, 1918-2813 online, Open Access

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Original Article

Volume 18, Number 1, February 2025, pages 12-22

Trends and Financial Burden of Gastrointestinal Stromal Tumors in the United States: A Comprehensive Analysis of United States Hospitalizations

Figure 1. Annual trends in hospitalizations for gastrointestinal stromal tumors: analysis of the National Inpatient Sample 2016 - 2020.

Figure 2. Distribution of gastrointestinal stromal tumor-related hospitalizations based on hospital location in the United States (2016 - 2020): analysis of the National Inpatient Sample 2016 - 2020.

Figure 3. Annual trends in percentage distribution of gastrointestinal stromal tumors based on tumor location: analysis of the National Inpatient Sample 2016 - 2020.

Figure 4. Annual trends in inpatient mortality for gastrointestinal stromal tumors: analysis of the National Inpatient Sample 2016 - 2020.

Figure 5. Annual trends in length of hospital stay for gastrointestinal stromal tumors: analysis of the National Inpatient Sample 2016 - 2020.

**Table 1.** Baseline Characteristics of GIST Hospitalizations From NIS 2016 - 2020
Characteristics	2016	2017	2018	2019	2020
GIST: gastrointestinal stromal tumor; NIS: National Inpatient Sample.
Total	2,645	10,455	11,550	12,475	11,565
Age (years), N (%)
18 - 44	160 (6.0%)	655 (6.3%)	855 (7.4%)	785 (6.3%)	830 (7.2%)
45 - 64	960 (36.3%)	3,740 (35.8%)	3,955 (34.2%)	4,265 (34.2%)	3,775 (32.6%)
65 - 84	1,280 (48.4%)	5,235 (50.1%)	5,740 (49.7%)	6,245 (50.1%)	5,915 (51.1%)
> 84	250 (9.5%)	825 (7.9%)	1,000 (8.7%)	1,180 (9.5%)	1,020 (8.8%)
Sex, N (%)
Male	1,355 (51.2%)	5,420 (51.8%)	5,940 (51.4%)	6,300 (50.5%)	5,700 (49.3%)
Female	1,290 (48.8%)	5,035 (48.2%)	5,610 (48.6%)	6,175 (49.5%)	5,865 (50.7%)
Race, N (%)
White	1,595 (60.3%)	6,010 (57.5%)	6,725 (58.2%)	7,380 (59.2%)	6,790 (58.7%)
Black	535 (20.2%)	2,170 (20.8%)	2,540 (22.0%)	2,675 (21.4%)	2,360 (20.4%)
Hispanic	155 (5.9%)	835 (8.0%)	935 (8.1%)	1,030 (8.3%)	1,105 (9.6%)
Asian or Pacific Islander	130 (4.9%)	650 (6.2%)	545 (4.7%)	735 (5.9%)	725 (6.3%)
Native American	15 (0.6%)	35 (0.3%)	30 (0.3%)	40 (0.3%)	25 (0.2%)
Other	95 (3.6%)	420 (4.0%)	490 (4.2%)	395 (3.2%)	360 (3.1%)
Region of hospital, N (%)
Northeast	560 (21.2%)	2,055 (19.7%)	2,290 (19.8%)	2,655 (21.3%)	2,335 (20.2%)
Midwest	565 (21.4%)	2,415 (23.1%)	2,485 (21.5%)	2,620 (21.0%)	2,345 (20.3%)
South	925 (35.0%)	3,695 (35.3%)	4,230 (36.6%)	4,580 (36.7%)	4,290 (37.1%)
West	600 (22.7%)	2,290 (21.9%)	2,545 (22.0%)	2,620 (21.0%)	2,595 (22.4%)
Status of the hospital, N (%)
Rural	115 (4.3%)	405 (3.9%)	475 (4.1%)	420 (3.4%)	475 (4.1%)
Urban non-teaching	430 (16.3%)	1,675 (16.0%)	1,515 (13.1%)	1,390 (11.1%)	1,520 (13.1%)
Urban teaching	2,105 (79.6%)	8,375 (80.1%)	9,560 (82.8%)	10,665 (85.5%)	9,570 (82.7%)
Median household income for patient’s zip code (based on current year), N (%)
0 to 25th percentile	710 (26.8%)	2,725 (26.1%)	3,135 (27.1%)	3,255 (26.1%)	2,820 (24.4%)
26th to 50th percentile (median)	560 (21.2%)	2,325 (22.2%)	2,780 (24.1%)	2,680 (21.5%)	2,855 (24.7%)
51st to 75th percentile	650 (24.6%)	2,505 (24.0%)	2,735 (23.7%)	3,090 (24.8%)	2,645 (22.9%)
76th to 100th percentile	655 (24.8%)	2,745 (26.3%)	2,775 (24.0%)	3,320 (26.6%)	3,105 (26.8%)
Variable	Cumulative value, N (%) (2016 - 2020)
Total (2016 - 2020)	48,695
Congestive heart failure	4,950 (10.2%)
Chronic pulmonary disease	7,545 (15.5%)
Hypertension	29,575 (60.7%)
Diabetes mellitus	12,135 (24.9%)
Hypothyroidism	6,565 (13.5%)
Renal failure	6,890 (14.1%)
Liver disease	3,334 (6.8%)
Peptic ulcer disease with bleeding	2,130 (4.4%)
Metastatic cancer	7,665 (15.7%)
Elective admission	18,610 (38.2%)
Non-elective admission	30,030 (61.7%)
Coagulopathy	3,200 (6.6%)
Chronic blood loss anemia	2,050 (4.2%)
Alcohol abuse	1,340 (2.8%)
Drug abuse	609 (1.3%)

Table 1. Baseline Characteristics of GIST Hospitalizations From NIS 2016 - 2020

Characteristics

2016

2017

2018

2019

2020

GIST: gastrointestinal stromal tumor; NIS: National Inpatient Sample.

Total

2,645

10,455

11,550

12,475

11,565

Age (years), N (%)

18 - 44

160 (6.0%)

655 (6.3%)

855 (7.4%)

785 (6.3%)

830 (7.2%)

45 - 64

960 (36.3%)

3,740 (35.8%)

3,955 (34.2%)

4,265 (34.2%)

3,775 (32.6%)

65 - 84

1,280 (48.4%)

5,235 (50.1%)

5,740 (49.7%)

6,245 (50.1%)

5,915 (51.1%)

> 84

250 (9.5%)

825 (7.9%)

1,000 (8.7%)

1,180 (9.5%)

1,020 (8.8%)

Sex, N (%)

Male

1,355 (51.2%)

5,420 (51.8%)

5,940 (51.4%)

6,300 (50.5%)

5,700 (49.3%)

Female

1,290 (48.8%)

5,035 (48.2%)

5,610 (48.6%)

6,175 (49.5%)

5,865 (50.7%)

Race, N (%)

White

1,595 (60.3%)

6,010 (57.5%)

6,725 (58.2%)

7,380 (59.2%)

6,790 (58.7%)

Black

535 (20.2%)

2,170 (20.8%)

2,540 (22.0%)

2,675 (21.4%)

2,360 (20.4%)

Hispanic

155 (5.9%)

835 (8.0%)

935 (8.1%)

1,030 (8.3%)

1,105 (9.6%)

Asian or Pacific Islander

130 (4.9%)

650 (6.2%)

545 (4.7%)

735 (5.9%)

725 (6.3%)

Native American

15 (0.6%)

35 (0.3%)

30 (0.3%)

40 (0.3%)

25 (0.2%)

Other

95 (3.6%)

420 (4.0%)

490 (4.2%)

395 (3.2%)

360 (3.1%)

Region of hospital, N (%)

Northeast

560 (21.2%)

2,055 (19.7%)

2,290 (19.8%)

2,655 (21.3%)

2,335 (20.2%)

Midwest

565 (21.4%)

2,415 (23.1%)

2,485 (21.5%)

2,620 (21.0%)

2,345 (20.3%)

South

925 (35.0%)

3,695 (35.3%)

4,230 (36.6%)

4,580 (36.7%)

4,290 (37.1%)

West

600 (22.7%)

2,290 (21.9%)

2,545 (22.0%)

2,620 (21.0%)

2,595 (22.4%)

Status of the hospital, N (%)

Rural

115 (4.3%)

405 (3.9%)

475 (4.1%)

420 (3.4%)

475 (4.1%)

Urban non-teaching

430 (16.3%)

1,675 (16.0%)

1,515 (13.1%)

1,390 (11.1%)

1,520 (13.1%)

Urban teaching

2,105 (79.6%)

8,375 (80.1%)

9,560 (82.8%)

10,665 (85.5%)

9,570 (82.7%)

Median household income for patient’s zip code (based on current year), N (%)

0 to 25th percentile

710 (26.8%)

2,725 (26.1%)

3,135 (27.1%)

3,255 (26.1%)

2,820 (24.4%)

26th to 50th percentile (median)

560 (21.2%)

2,325 (22.2%)

2,780 (24.1%)

2,680 (21.5%)

2,855 (24.7%)

51st to 75th percentile

650 (24.6%)

2,505 (24.0%)

2,735 (23.7%)

3,090 (24.8%)

2,645 (22.9%)

76th to 100th percentile

655 (24.8%)

2,745 (26.3%)

2,775 (24.0%)

3,320 (26.6%)

3,105 (26.8%)

Variable

Cumulative value, N (%) (2016 - 2020)

Total (2016 - 2020)

48,695

Congestive heart failure

4,950 (10.2%)

Chronic pulmonary disease

7,545 (15.5%)

Hypertension

29,575 (60.7%)

Diabetes mellitus

12,135 (24.9%)

Hypothyroidism

6,565 (13.5%)

Renal failure

6,890 (14.1%)

Liver disease

3,334 (6.8%)

Peptic ulcer disease with bleeding

2,130 (4.4%)

Metastatic cancer

7,665 (15.7%)

Elective admission

18,610 (38.2%)

Non-elective admission

30,030 (61.7%)

Coagulopathy

3,200 (6.6%)

Chronic blood loss anemia

2,050 (4.2%)

Alcohol abuse

1,340 (2.8%)

Drug abuse

609 (1.3%)

**Table 2.** Annual Trends in Mortality, Tumor Location, Hospital Stay, and Treatment Costs for GISTs From NIS 2016 - 2020
	2016	2017	2018	2019	2020	P-trend
GISTs: gastrointestinal stromal tumors; NIS: National Inpatient Sample.
Mortality, N (%)	110 (4.16%)	290 (2.77%)	380 (3.29%)	335 (2.69%)	380 (3.29%)	0.807
Tumor location
Esophageal	25 (0.9%)	90 (0.9%)	110 (1.0%)	125 (1.0%)	105 (0.9%)
Stomach	1,335 (50.5%)	5,335 (51.0%)	5,735 (49.7%)	5,880 (47.1%)	5,330 (46.1%)
Small intestine	465 (17.6%)	1,790 (17.1%)	2,105 (18.2%)	2,455 (19.7%)	2,280 (19.7%)
Large intestine	75 (2.8%)	295 (2.8%)	515 (4.5%)	465 (3.7%)	395 (3.4%)
Rectum	45 (1.7%)	170 (1.6%)	145 (1.3%)	215 (1.7%)	205 (1.8%)
Unspecified	625 (23.6%)	2,405 (23.0%)	2,755 (23.9%)	3,045 (24.4%)	2,900 (25.1%)
Length of hospital stay, N (%)
Fewer than 5 days	1,550 (59.16%)	6,235 (60.24%)	7,245 (63.55%)	7,550 (61.21%)	7,020 (61.39%)	< 0.0001
5 days or more	1,070 (40.84%)	4,115 (39.76%)	4,155 (36.45%)	4,785 (38.79%)	4,415 (38.61%)
Total hospital charge (USD), N (%)
Up to 10,000	905 (34.9%)	3,485 (33.4%)	4,005 (34.7%)	3,925 (31.6%)	3,240 (28.3%)
10,000 - 20,000	945 (36.5%)	3,855 (36.9%)	4,295 (37.2%)	4,480 (36.1%)	3,975 (34.7%)
20,000 - 30,000	325 (12.5%)	1,570 (15.1%)	1,675 (14.5%)	1,920 (15.5%)	2,000 (17.5%)
30,000 - 40,000	200 (7.7%)	690 (6.6%)	635 (5.5%)	755 (6.1%)	795 (6.9%)
More than 40,000	215 (8.3%)	820 (7.9%)	925 (8.0%)	1,335 (10.7%)	1,445 (12.6%)
Mean total hospital charge adjusted for inflation (USD)	20,242	19,373	18,902	21,033	22,905	< 0.0001

Table 2. Annual Trends in Mortality, Tumor Location, Hospital Stay, and Treatment Costs for GISTs From NIS 2016 - 2020

2016

2017

2018

2019

2020

P-trend

GISTs: gastrointestinal stromal tumors; NIS: National Inpatient Sample.

Mortality, N (%)

110 (4.16%)

290 (2.77%)

380 (3.29%)

335 (2.69%)

380 (3.29%)

0.807

Tumor location

Esophageal

25 (0.9%)

90 (0.9%)

110 (1.0%)

125 (1.0%)

105 (0.9%)

Stomach

1,335 (50.5%)

5,335 (51.0%)

5,735 (49.7%)

5,880 (47.1%)

5,330 (46.1%)

Small intestine

465 (17.6%)

1,790 (17.1%)

2,105 (18.2%)

2,455 (19.7%)

2,280 (19.7%)

Large intestine

75 (2.8%)

295 (2.8%)

515 (4.5%)

465 (3.7%)

395 (3.4%)

Rectum

45 (1.7%)

170 (1.6%)

145 (1.3%)

215 (1.7%)

205 (1.8%)

Unspecified

625 (23.6%)

2,405 (23.0%)

2,755 (23.9%)

3,045 (24.4%)

2,900 (25.1%)

Length of hospital stay, N (%)

Fewer than 5 days

1,550 (59.16%)

6,235 (60.24%)

7,245 (63.55%)

7,550 (61.21%)

7,020 (61.39%)

< 0.0001

5 days or more

1,070 (40.84%)

4,115 (39.76%)

4,155 (36.45%)

4,785 (38.79%)

4,415 (38.61%)

Total hospital charge (USD), N (%)

Up to 10,000

905 (34.9%)

3,485 (33.4%)

4,005 (34.7%)

3,925 (31.6%)

3,240 (28.3%)

10,000 - 20,000

945 (36.5%)

3,855 (36.9%)

4,295 (37.2%)

4,480 (36.1%)

3,975 (34.7%)

20,000 - 30,000

325 (12.5%)

1,570 (15.1%)

1,675 (14.5%)

1,920 (15.5%)

2,000 (17.5%)

30,000 - 40,000

200 (7.7%)

690 (6.6%)

635 (5.5%)

755 (6.1%)

795 (6.9%)

More than 40,000

215 (8.3%)

820 (7.9%)

925 (8.0%)

1,335 (10.7%)

1,445 (12.6%)

Mean total hospital charge adjusted for inflation (USD)

20,242

19,373

18,902

21,033

22,905

< 0.0001

**Table 3.** Trends in Endoscopic and Surgical Interventions for GISTs From NIS 2016 - 2020
	2016	2017	2018	2019	2020	Total	P-trend
GISTs: gastrointestinal stromal tumors; NIS: National Inpatient Sample.
Endoscopic excision, N (%)	69 (13.02%)	228 (10.9%)	246 (10.65%)	296 (11.86%)	301 (13.01%)	1,140	0.08
Surgical resection, N (%)	21 (3.96%)	107 (5.12%)	107 (4.63%)	123 (4.93%)	131 (5.66%)	489	0.16
Surgical excision, N (%)	142 (26.8%)	490 (23.4%)	539 (23.3%)	544 (21.8%)	494 (21.4%)	2,209	0.0045

Table 3. Trends in Endoscopic and Surgical Interventions for GISTs From NIS 2016 - 2020

2016

2017

2018

2019

2020

Total

P-trend

GISTs: gastrointestinal stromal tumors; NIS: National Inpatient Sample.

Endoscopic excision, N (%)

69 (13.02%)

228 (10.9%)

246 (10.65%)

296 (11.86%)

301 (13.01%)

1,140

0.08

Surgical resection, N (%)

21 (3.96%)

107 (5.12%)

107 (4.63%)

123 (4.93%)

131 (5.66%)

489

0.16

Surgical excision, N (%)

142 (26.8%)

490 (23.4%)

539 (23.3%)

544 (21.8%)

494 (21.4%)

2,209

0.0045