Abstract
Admission in ICU (Intensive Care Unit) of patients with lung cancer is still debated. The argument against admission is often their bad prognosis.
We retrospectively included all consecutive patients with a lung cancer histologically proved admitted in ICU for more than 24 hours between January 2003 and December 2010.
104 patients were included with a median SAPS 2 of 54.5; 52% of patients were metastatic. 55 (53%) patients needed invasive mechanical ventilation. Mortality rates in ICU, in hospital and at one year were respectively 31.7%, 48% and 83.7%. Prognostic factors were SAPS 2 score ≥ 42 (OR 2,65 IC 95% (1,10-6,36), p=0,03), invasive mechanical ventilation (OR 4,88 IC 95% (1,86- 12,76), p=0,012), vasopressive treatments (OR 6,26 IC95% (2,52- 15,57), p<0,001) and organ dysfunction with need of mechanical invasive ventilation or non-invasive ventilation or vasopressive treatments or dialysis (OR 5,5 IC95% (1,12- 27,2), p=0,0002) in univariate analysis. 75% of survivors of ICU will benefit of specific anticancer treatment after their hospitalisation in ICU. In a Kaplan-Meier survival curve, metastasis group and without metastasis group have a significant difference of median survival whatever the acute complication that conducted to ICU admission (p=0.019).
Prognostic factors in ICU seems to be related to the acute pathology, otherwise long term prognosis is determined by cancer prognosis.
- © 2012 ERS
