Chih-Cheng Lai1, Chung-Han Ho2,3, Chin-Ming Chen4,5, Shyh-Ren Chiang5,6, Chien-Ming Chao1, Wei-Lun Liu7, Jhi-Joung Wang2, Ching-Chieh Yang8,9,10, Kuo-Chen Cheng6,11. 1. Department of Intensive Care Medicine, Chi Mei Medical Center, Liouying. 2. Department of Medical Research, Chi Mei Medical Center, Tainan. 3. Department of Hospital and Health Care Administration, Chia-Nan University of Pharmacy and Science, Tainan. 4. Department of Intensive Care Medicine, Chi Mei Medical Center, Tainan. 5. Chia Nan University of Pharmacy and Science, Tainan. 6. Internal Medicine, Chi Mei Medical Center, Tainan. 7. Department of Emergency and Critical Care Medicine, Fu Jen Catholic University Hospital, New Taipei. 8. Department of Radiation Oncology, Chi-Mei Medical Center, Tainan. 9. Institute of Biomedical Sciences, National Sun Yat-Sen University, Kaohsiung. 10. Department of Biotechnology, Chia-Nan University of Pharmacy and Science, Tainan. 11. Department of Safety, Health, and Environmental Engineering, Chung Hwa University of Medical Technology, Tainan.
Abstract
BACKGROUND: This study aims to investigate lung cancer patients' risk factors for: intensive care unit (ICU) admission, infectious complications and organ dysfunction in the ICU, and prognosis after ICU admission. METHODS: The records of all patients with lung-cancer catastrophic-illness cards admitted to the ICU between 2003 and 2012 were reviewed. The primary endpoint was 1-year mortality. RESULTS: We finally analyzed the records of index-date-, age-, and sex-matched ICU-admitted (ICU+) lung cancer patients (n=17,687) and ICU-non-admitted (ICU-) lung cancer patients (n=35,374). The overall 1-year mortality rate was significantly (P<0.0001) higher for ICU+ patients (49.91%) than for ICU- patients (44.86%). Most ICU+ patients (56.16%) had infectious complications and organ dysfunction (52.33%), and overall, 6,893 (38.97%) had sepsis. Independent mortality risk factors were age (≥75 years) [adjusted hazard ratio (AHR), 1.22; 95% confidence interval (CI), 1.16-1.29], male sex: (AHR, 1.18; 95% CI, 1.13-1.23), recent radiotherapy (AHR, 1.09; 95% CI, 1.04-1.15), infectious complications (AHR: 1.23; 95% CI: 1.17-1.29), organ dysfunction (AHR, 1.57; 95% CI, 1.50-1.65), and hospital level (regional hospital: AHR, 1.11; 95% CI, 1.06-1.16; local hospital: AHR, 1.28; 95% CI, 1.18-1.37). CONCLUSIONS: ICU admission for lung cancer patients is associated with higher mortality. Several risk factors of mortality for ICU+ patients should help physicians provide patients personalized and better-informed lung cancer therapy decisions.
BACKGROUND: This study aims to investigate lung cancer patients' risk factors for: intensive care unit (ICU) admission, infectious complications and organ dysfunction in the ICU, and prognosis after ICU admission. METHODS: The records of all patients with lung-cancer catastrophic-illness cards admitted to the ICU between 2003 and 2012 were reviewed. The primary endpoint was 1-year mortality. RESULTS: We finally analyzed the records of index-date-, age-, and sex-matched ICU-admitted (ICU+) lung cancer patients (n=17,687) and ICU-non-admitted (ICU-) lung cancer patients (n=35,374). The overall 1-year mortality rate was significantly (P<0.0001) higher for ICU+ patients (49.91%) than for ICU- patients (44.86%). Most ICU+ patients (56.16%) had infectious complications and organ dysfunction (52.33%), and overall, 6,893 (38.97%) had sepsis. Independent mortality risk factors were age (≥75 years) [adjusted hazard ratio (AHR), 1.22; 95% confidence interval (CI), 1.16-1.29], male sex: (AHR, 1.18; 95% CI, 1.13-1.23), recent radiotherapy (AHR, 1.09; 95% CI, 1.04-1.15), infectious complications (AHR: 1.23; 95% CI: 1.17-1.29), organ dysfunction (AHR, 1.57; 95% CI, 1.50-1.65), and hospital level (regional hospital: AHR, 1.11; 95% CI, 1.06-1.16; local hospital: AHR, 1.28; 95% CI, 1.18-1.37). CONCLUSIONS: ICU admission for lung cancer patients is associated with higher mortality. Several risk factors of mortality for ICU+ patients should help physicians provide patients personalized and better-informed lung cancer therapy decisions.
Entities:
Keywords:
Lung cancer; intensive care unit; mortality; risk factor; sepsis
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