Risk of ICU Admission in Patients With Lung Cancer
Posted: Monday, April 27, 2020
A study published in BMC Pulmonary Medicine found that of the 1.5% of patients with lung cancer who were admitted to the intensive care unit (ICU) within 2 years of diagnosis, both short-term and long-term survival outcomes were poor. Surgical treatment increased the risk of ICU admission, whereas older age, female gender, and radiotherapy or chemotherapy were associated with a decreased risk.
“ICU admission was greatest in the period shortly after cancer diagnosis, and this is likely to reflect patients developing critical illness as a consequence of active cancer or its treatment,” stated Kathryn Puxty, MBChB, MD, of the University of Glasgow, United Kingdom, and colleagues.
This retrospective, observational, population-based study included 26,731 cases of adult lung cancer diagnosed between January 2000 and December 2009 in the West of Scotland. A total of 398 patients (1.5%) were admitted to an ICU within 2 years of a lung cancer diagnosis.
The median time from lung cancer diagnosis to admission was 52 days. Patients were most commonly admitted with respiratory conditions, and the majority of patients with lung cancer admitted to the ICU required invasive mechanical ventilation (70.9%). Mortality rates in the ICU, in the hospital, and 6 months after admission were 41.5%, 58.0%, and 68.8%, respectively.
Surgical treatment of lung cancer increased the odds of ICU admission (odds ratio = 7.23). Odds of admission to the ICU were reduced with increasing age, female gender (odds ratio = 0.73), and radiotherapy or chemotherapy (odds ratio = 0.54 and 0.52, respectively). “It is unclear why some factors that are usually associated with a better prognosis, such as younger age and surgical treatment, are associated with greater risks of ICU admission,” stated the researchers. “Further prospective research is needed.”
Disclosure: The study authors reported no conflicts of interest.