The prognosis of patients with lung cancer admitted to the medical intensive care unit

• Published in: Asia-Pacific journal of clinical oncology Vol. 12; no. 1; pp. e118 - e124
• Main Authors: Hwang, Ki-Eun, Seol, Chang-Hwan, Hwang, Yu-Ri, Jo, Hoon-Gil, Park, Seong-Hoon, Yoon, Kwon-Ha, Park, Do-Sim, Jeong, Eun-Taik, Kim, Hak-Ryul
• Format: Journal Article
• Language: English
• Published: Australia Blackwell Publishing Ltd 01-03-2016; Wiley Subscription Services, Inc
• Subjects: Aged; Carcinoma, Non-Small-Cell Lung - complications; Carcinoma, Non-Small-Cell Lung - mortality; Carcinoma, Non-Small-Cell Lung - pathology; Diabetes mellitus; Female; Hospital Mortality; Humans; Intensive care; Intensive Care Units - statistics & numerical data; Lung cancer; Lung Neoplasms - complications; Lung Neoplasms - mortality; Lung Neoplasms - pathology; Male; Mechanical ventilation; medical intensive care unit; Middle Aged; Mortality; Patients; Prognosis; Renal failure; Retrospective Studies; Small Cell Lung Carcinoma - complications; Small Cell Lung Carcinoma - mortality; Small Cell Lung Carcinoma - pathology; Vasoactive agents; lung cancer; prognosis; medical intensive care unit
• ISSN: 1743-7555; 1743-7563
• DOI: 10.1111/ajco.12157

Aims
Lung cancer remains the leading cause of cancer mortality worldwide. Despite their poor prognosis, patients with lung cancer are increasingly being admitted to the medical intensive care unit (MICU) for treatment of critical illnesses. The aim of this study was to assess the outcome of patients with lung cancer who are admitted to an MICU and to identify the measurable predictors of their MICU outcome.
Methods
We conducted retrospective analysis on 97 patients with lung cancer admitted to the MICU between 2007 and 2011.
Results
The mean age ± standard deviation was 71.8 ± 6.8 years. Of the 97 patients (82 male), 73 patients (75%) had non‐small cell lung cancer stage IIIB, IV and 24 patients (25%) had small cell lung cancer. The intensive care unit mortality and in‐hospital mortality rates were 53.6 and 61.8%. The main reasons for MICU admission were pneumonia (n = 51) and complication of cancer management (n = 45). The predictors of poor MICU outcome were history of diabetes mellitus (P = 0.028), Acute Physiology and Chronic Health Evaluation II score (P = 0.018), need for mechanical ventilation (P = 0.014), use of vasoactive agents (P < 0.0001), the presence of acute renal failure (P < 0.0001) and presence of multiorgan failure (P < 0.0001).
Conclusions
We found that in‐hospital mortality was not influenced by age, sex or performance status score of patients with lung cancer but increased with the severity of organ failure at MICU admission.