Abstract
The decision-making process for the intensity of care delivered to patients with lung cancer and organ failure is poorly understood, and does not always involve intensivists. Our objective was to describe the potential suitability for intensive care unit (ICU) referral of lung cancer in-patients with organ failures.
We prospectively included consecutive lung cancer patients with failure of at least one organ admitted to the teaching hospital in Grenoble, France, between December 2010 and October 2012.
Of 140 patients, 121 (86%) were evaluated by an oncologist and 49 (35%) were referred for ICU admission, with subsequent admission for 36 (73%) out of those 49. Factors independently associated with ICU referral were performance status ⩽2 (OR 10.07, 95% CI 3.85–26.32), nonprogressive malignancy (OR 7.00, 95% CI 2.24–21.80), and no explicit refusal of ICU admission by the patient and/or family (OR 7.95, 95% CI 2.39–26.37). Factors independently associated with ICU admission were the initial ward being other than the lung cancer unit (OR 6.02, 95% CI 1.11–32.80) and an available medical ICU bed (OR 8.19, 95% CI 1.48–45.35).
Only one-third of lung cancer patients with organ failures were referred for ICU admission. The decision not to consider ICU admission was often taken by a non-intensivist, with advice from an oncologist rather than an intensivist.
Abstract
The decision not to consider ICU admission of lung cancer patients is often taken by a non-intensivist physician http://ow.ly/C4bNB
Footnotes
For editorial comments see Eur Respir J 2015; 45: 308–309 [DOI: 10.1183/09031936.00198714]
This article has supplementary material available from erj.ersjournals.com
Clinical trial: This study is registered at www.clinicaltrials.gov with identifier number NCT00222404.
Support statement: This project received funding from the publicly funded, non-profit organisation Cancéropole Lyon Auvergne Rhône-Alpes.
Conflict of interest: Disclosures can be found alongside the online version of this article at erj.ersjournals.com
- Received June 27, 2014.
- Accepted September 17, 2014.
- Copyright ©ERS 2015