1270P Clinical outcomes in treatments of intensive care unit for lung cancer patients

Abstract

Patients with advanced lung cancer often need intensive care unit (ICU) care, as result of its high morbidity and mortality. However, there is controversy regarding the benefit from intensive treatments in patients with lung cancer. We analyzed clinical outcomes of patients with lung cancer who had ever been treated with ICU care. All patients >18 year of age with newly diagnosed lung cancer between 2008.1.1 ∼ 2010. 12.31 were extracted from the claims data from the Health insurance review and assessment service (HI-RA). (code C34.x of the International Classification of Diseases 10th revision) The claims data for extracted patients were followed by December 31, 2015. We analyzed clinical outcomes including mortality of admissions to ICU. After lung cancer diagnosis, 21.2% (n=36,318) of lung cancer patients were treated in ICU. 55.8% (n=16,083) of them were admitted to ICU for medical reasons. Lung cancer patients with ICU care were predominantly male (71.6% vs 64.2%) and older (66.1±10.7 vs 65.8±12.0) than those without ICU care. Patients with ICU care experienced more respiratory failure (56.5% vs. 8.4%) and more cardiopulmonary resuscitation (14.0% vs. 4.2%). Within 1 year of diagnosis, mortality was lower in patients with ICU care than those without ICU care at 180 days (30.6% vs 40.6%) and at 1 year (47.6% vs. 53.3%). However, patients with ICU care showed worse long-term mortality than those without ICU care at 2 years and 5 years. Our study suggested ICU management might not be futile in all lung cancer patients. It need further classification of critically ill patients with lung cancer according to outcome predictors. The precise decision for ICU management could improve outcomes of these patients without prolonging a painful dying process.