P1.05 Lung Cancer Patients – Major Causes of Hospitalization and Mortality

Abstract

Lung cancer (LC) is the leading cause of cancer-related mortality and a major source of morbidity and health care costs with high hospitalization rates. The aim of this study was to identify the major causes of hospitalization and of mortality in patients with LC at a district hospital. A retrospective analysis of patient’s clinical records admitted in the Pneumology ward of our hospital from May 2014 to May 2019 with LC diagnosis was performed. We characterized patients according to demographic characteristic, comorbidities, histology, clinical stage, causes of hospitalization and outcome. 246 patients (392 admissions) were analyzed. 72.4% were male. Mean age was 66.5 ± 10.2 years. 78.5% had active or past smoking habits. The most prevalent comorbidities were cardiovascular disease (48.8%) and chronic obstructive pulmonary disease (34.6%). Adenocarcinoma was the most frequent histology found (57.3%). 65.7% of patients had advanced stage disease at admission and 68.3% were under active therapeutics. The median length of hospitalization was 10 days (IQR 6-18). The major causes of hospitalization were respiratory infection (26.5%) and disease progression (18.4%). We found that empirical antibiotic therapy was used in 44.6% of admissions, only 11.2% of patients had positive bacteriological tests (most common bacteria identified were Klebsiella pneumoniae and Escherichia coli). 74 patients (30.1%) died. We found a strong statistically significant association between mortality and advance stage disease (p value: 0,006) and disease progression as cause of hospitalization (p value: 0,001). Hospitalization ≥ 10 days was strongly associated with infectious intercurrence (p value: 0,0001) and with mortality (p value: 0,016). Respiratory infection represents a major cause of admissions of LC patients in our ward. These patients have multiple causes for immunosuppression, therefore high suspicion and early intervention are needed to minimize the impact on patient’s quality of life, length of hospitalization and associated mortality. Disease progression was the second cause, so in order to optimize end of life strategies and avoid potentially unnecessary admissions we reinforce the need of a palliative care with a multidisciplinary approach.