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01-12-2009 | Original

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

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

Published in: Intensive Care Medicine | Issue 12/2009

Abstract

Background

Intensive 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.

Objectives

To identify predictive factors of hospital and 6-month mortality in critically ill lung-cancer patients.

Design and setting

Retrospective study conducted in the ICU of a university hospital.

Patients

One hundred five consecutive lung-cancer patients included between 1 January 1997 and 31 December 2006.

Interventions

None.

Results

Of 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.

Conclusions

ICU admission should be considered in selected patients with lung cancer (PS <2, no cancer disease progression).

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Title: Six-month prognosis of patients with lung cancer admitted to the intensive care unit
Authors: Sébastien Roques
Antoine Parrot
Armelle Lavole
Pierre-Yves Ancel
Valérie Gounant
Michel Djibre
Muriel Fartoukh
Publication date: 01-12-2009
Publisher: Springer-Verlag
Published in: Intensive Care Medicine / Issue 12/2009
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI: https://doi.org/10.1007/s00134-009-1625-y

Keynote webinar | Spotlight on medication adherence

Springer Medicine

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

Abstract

Background

Objectives

Design and setting

Patients

Interventions

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Objectives

Design and setting

Patients

Interventions

Results

Conclusions

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