Inpatient outcomes of bladder cancer: Racial and socioeconomic disparities in a nationally representative sample (2020-2022).

873 Background: Bladder cancer is the sixth most common malignancy in the United States (U.S.) and continues to impose substantial inpatient morbidity and cost. While race and sociodemographic factors affect hospitalization outcomes broadly, their impact in bladder cancer remains understudied. This study evaluated racial and socioeconomic disparities among U.S. adults with bladder cancer using a nationally representative dataset. Methods: The National Inpatient Sample (NIS) 2020-2022 was analyzed to identify adult hospitalizations with bladder cancer using ICD-10 codes. Outcomes included in-hospital mortality, length of stay (LOS), discharge disposition, and total hospital charges. Race was categorized as White (reference), Black, Hispanic, and Other. Multivariate logistic and linear regression models assessed correlations, adjusting for demographic, clinical, and hospital-level factors. Results: A total of 257,710 hospitalizations were identified: 79.5% White, 8.1% Black, 5.7% Hispanic, and 6.7% Other. Black (31.8%) and Hispanic (26.6%) patients were more often younger than 65 years than White patients (17.2%). Socioeconomic disparities were significant, with 47.9% of Black and 35.0% of Hispanic patients in the lowest income quartile versus 22.0% of White patients. Female representation was higher among Black (35.8%) than White (22.8%) patients. Medicare was the main payer but less common among Black and Hispanic patients, who had higher Medicaid use (14.2% and 13.9% vs 4.1% of White). Most admissions were non-elective and occurred at urban teaching hospitals. Crude in-hospital mortality was 5.0%. On adjusted analyses, Black patients had higher odds of mortality (OR 1.31, p < 0.05) and non-home discharge (OR 1.14, p < 0.05) versus White patients. LOS was longer among Black (+0.8 days, p < 0.05) and Hispanic (+0.5 days, p < 0.05) patients. Adjusted charges were higher for Black (+$4,683, p < 0.05), Hispanic (+$15,070, p < 0.05), and Other (+$6,567, p < 0.05) patients. Conclusions: Racial and socioeconomic disparities persist among hospitalized patients with bladder cancer in the U.S. Black patients experienced higher inpatient mortality, longer stays, greater odds of non-home discharge, and higher costs than White patients, while Hispanic and Other groups had similar mortality but higher costs. Targeted strategies are needed to reduce inequities in inpatient outcomes and resource utilization.