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Six-month prognosis of patients with lung cancer admitted to the intensive care unit

Intensive Care Medicine Aims and scope Submit manuscript

Abstract

Background

Intensive care unit (ICU) admission of patients with lung cancer remains debated because of the poor short-term prognosis. However, ICU admission of such patients should also be assessed on the possibility to administer specific anticancer treatment and the long-term outcome thereafter.

Objectives

To identify predictive factors of hospital and 6-month mortality in critically ill lung-cancer patients.

Design and setting

Retrospective study conducted in the ICU of a university hospital.

Patients

One hundred five consecutive lung-cancer patients included between 1 January 1997 and 31 December 2006.

Interventions

None.

Results

Of the 105 patients (mean age 64.8 years), 87 (83%) had a non-small cell lung cancer (NSCLC). Extensive disease was diagnosed in 85 patients (83%) (NSCLC stages IIIB and IV or disseminated small cell lung cancer). The main reasons for ICU admission were acute respiratory failure (59%) and/or hemoptysis (45%). Forty-three patients (41%) needed mechanical ventilation (MV). The ICU, hospital and 6-month mortality rates were 43, 54 and 73%, respectively. A performance status (PS) ≥2 [odds ratio OR = 3.6 (95% confidence interval CI (1.5–8.7)] and acute respiratory failure [OR = 3.5 (95% CI (1.5–8.4)] predicted hospital mortality. In a multivariate Cox model, the cancer progression [hazard ratio HR = 6.1 (95% CI 2.2–17)] and the need for MV [HR = 3.6 (95% CI 1.35–9.4)] were independently associated with 6-month mortality. Two-thirds of the ICU survivors were able to receive anticancer treatment.

Conclusions

ICU admission should be considered in selected patients with lung cancer (PS <2, no cancer disease progression).

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Acknowledgment

The authors thank Ferima Sanogo for her technical help in the collection of data.

Conflict of interest statement

None.

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Correspondence to Antoine Parrot.

Additional information

This article is discussed in the editorial available at:doi:10.1007/s00134-009-1633-y.

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Roques, S., Parrot, A., Lavole, A. et al. Six-month prognosis of patients with lung cancer admitted to the intensive care unit. Intensive Care Med 35, 2044–2050 (2009). https://doi.org/10.1007/s00134-009-1625-y

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  • DOI: https://doi.org/10.1007/s00134-009-1625-y

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