Six-month survival of patients with lung cancer admitted to a medical ICU: a retrospective study

Introduction

ICU admission of patients with lung cancer remains debated because of the poor short-term prognosis. We evaluated the duration of survival of patients admitted to our ICU and looked for factors associated with better survival.

Methods

All patients with nonresectable lung cancer admitted to our ICU between 1 January 2008 and 31 December 2010 were included in a retrospective study. Postoperative patients were not included.

Results

Twenty-two patients were included. Seventeen had nonsmallcell lung cancer (NSCLC). One had small cell lung cancer. Fifteen patients (65%) had metastatic disease. Twelve patients were in palliative therapy. The reason for ICU admission was acute respiratory failure in 12 patients (55%), hemorrhage in five patients (23%). Nine patients (41%) had an infection. Fourteen patients (64%) needed invasive mechanical ventilation. One-month survival was 45% (10/22). Six-month survival was 13% (3/22). One-year survival was 0%. One-month survivors showed a nonsignificant trend to lower performance status and severity of disease. All 6-month survivors had metastatic disease. Six-month survivors had nonsignificantly lower performance status (1.7 ± 0.6 vs. 2.7 ± 1.2; P = NS). IGS II, SOFA score and duration of mechanical ventilation were significantly shorter in survivors (see Table 1).

Table 1 (abstract P410)

Conclusion

Prognosis of patients with nonresectable lung cancer admitted to the ICU was poor. Metastatic disease did not influence survival in our survey. Patients admitted for a critical illness requiring more than a few days of mechanical ventilation were very unlikely to survive over 6 months.