Outcome of Lung Cancer Patients Admitted to the Intensive Care Unit

Abstract

In Brief We investigate the outcome of lung cancer patients admitted to the medical intensive care unit (MICU) and examine potential predictors of mortality. A retrospective quality assurance study of primary lung cancer patients admitted to the MICUs at 2 local tertiary care university hospitals from January 1, 1994 to May 12, 2004 was conducted (n = 69). Data on demographics and tumor-related data were collected using the hospital records of all patients admitted to MICU with a diagnosis of lung cancer. Statistical analysis was performed to determine the prognostic factors associated with MICU and hospital mortality as well as MICU and hospital lengths of stay. The MICU mortality rate was 50.7% and the mean MICU length of stay was 3.0 days. Multivariate analysis determined that Acute Physiology and Chronic Health Evaluation (APACHE II) scores, Therapeutic Intervention Scoring System scores, and non-small cell lung cancer were significantly associated with MICU mortality, whereas age and APACHE II scores were associated with hospital mortality. Respiratory failure upon admission and use of a Swan Ganz monitor were predictors of increased MICU length of stay, and chemotherapy administration and mechanical ventilation predicted increased hospital length of stay. The 50.7% mortality rate for patients with previously or newly diagnosed primary lung cancer admitted to the MICU is lower than the previously reported mortality rate of 66.7% for a period of 1986. Although the mortality remains high, an improvement over the previous decade has occurred and is comparable to that for patients requiring MICU admission for other indications. There is a high mortality rate associated with medical intensive care unit (MICU) admission for patients with previously or newly diagnosed primary lung cancer. However, it has improved over the previous decade and is comparable to that among patients requiring MICU admission for other illness such as pneumonia, adult respiratory distress syndrome, sepsis, and cardiopulmonary resuscitation.