Youjin Chang1, Jin-Won Huh1, Sang-Bum Hong1, Dae Ho Lee2, Cheolwon Suh2, Sang-We Kim2, Chae-Man Lim1, Younsuck Koh3. 1. Department of Pulmonary and Critical Care Medicine, Asan Medical Center, College of Medicine, University of Ulsan, 86 Asanbyeongwon-gil, Songpa-gu, Seoul, 138-736, South Korea. 2. Department of Oncology, Asan Medical Center, College of Medicine, University of Ulsan, 86 Asanbyeongwon-gil, Songpa-gu, Seoul, 138-736, South Korea. 3. Department of Pulmonary and Critical Care Medicine, Asan Medical Center, College of Medicine, University of Ulsan, 86 Asanbyeongwon-gil, Songpa-gu, Seoul, 138-736, South Korea. Electronic address: yskoh@amc.seoul.kr.
Abstract
PURPOSE: To evaluate the outcomes and prognostic factors of 28-day mortality following medical intensive care unit (MICU) admission of patients with lung cancer and pneumonia-induced respiratory failure. MATERIALS AND METHODS: Patients admitted to the MICU of a tertiary referral hospital between 2000 and 2009 were retrospectively studied. RESULTS: In total, 143 patients were included. Their mean age was 65±8 years and 94% were male. The 28-day mortality rate was 57%. Multivariate analysis was performed to identify variables associated with 28-day mortality. At 72 hours after admission, a history of radiotherapy (OR=2.80, 95% CI: 1.15-6.78), PaO2/FiO2 (P/F) ratio at admission of <100 mmHg (OR=5.62, 95% CI: 2.10-15.07), P/F ratio after 72 hours of <100 mmHg (OR=4.61, 95% CI: 1.24-17.15), and arterial pH after 72 hours of <7.30 (OR=5.78, 95% CI: 1.15-28.89) were associated with increased mortality. CONCLUSIONS: The prognosis of patients with lung cancer and severe pneumonia after 72 hours of MICU management mainly depends on the severity of the underlying lung injury, which is reflected by a history of radiotherapy and a low P/F ratio, rather than on cancer stage or disease status.
PURPOSE: To evaluate the outcomes and prognostic factors of 28-day mortality following medical intensive care unit (MICU) admission of patients with lung cancer and pneumonia-induced respiratory failure. MATERIALS AND METHODS:Patients admitted to the MICU of a tertiary referral hospital between 2000 and 2009 were retrospectively studied. RESULTS: In total, 143 patients were included. Their mean age was 65±8 years and 94% were male. The 28-day mortality rate was 57%. Multivariate analysis was performed to identify variables associated with 28-day mortality. At 72 hours after admission, a history of radiotherapy (OR=2.80, 95% CI: 1.15-6.78), PaO2/FiO2 (P/F) ratio at admission of <100 mmHg (OR=5.62, 95% CI: 2.10-15.07), P/F ratio after 72 hours of <100 mmHg (OR=4.61, 95% CI: 1.24-17.15), and arterial pH after 72 hours of <7.30 (OR=5.78, 95% CI: 1.15-28.89) were associated with increased mortality. CONCLUSIONS: The prognosis of patients with lung cancer and severe pneumonia after 72 hours of MICU management mainly depends on the severity of the underlying lung injury, which is reflected by a history of radiotherapy and a low P/F ratio, rather than on cancer stage or disease status.
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