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


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2009-09-19

AUTHORS

Sébastien Roques, Antoine Parrot, Armelle Lavole, Pierre-Yves Ancel, Valérie Gounant, Michel Djibre, Muriel Fartoukh

ABSTRACT

BackgroundIntensive 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.ObjectivesTo identify predictive factors of hospital and 6-month mortality in critically ill lung-cancer patients.Design and settingRetrospective study conducted in the ICU of a university hospital.PatientsOne hundred five consecutive lung-cancer patients included between 1 January 1997 and 31 December 2006.InterventionsNone.ResultsOf 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.ConclusionsICU admission should be considered in selected patients with lung cancer (PS <2, no cancer disease progression). More... »

PAGES

2044

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00134-009-1625-y

DOI

http://dx.doi.org/10.1007/s00134-009-1625-y

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1038529996

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/19768453


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