Factors associated with survival in lung cancer patients admitted to intensive care: an analysis of the West of Scotland Critical Care and Cancer Patient Database


Year:

Session type:

Theme:

Christopher Grant1,Philip McLoone1,Billy Sloan1,Kathryn Puxty2,Tara Quasim2,David Morrison1
1University of Glasgow,2Glasgow Royal Infirmary

Abstract

Background

Lung cancer is the most common cause of cancer related death worldwide. Patients with lung cancer can develop a critical illness such that they may require treatment in an ICU. Limited ICU resource combined with poor survival historically resulted in few patients with lung cancer being admitted to an ICU. Our aim was to determine the factors are associated with survival in the ICU, in-hospital and at six months in patients from the West of Scotland (WOS) with lung cancer admitted to intensive care within two years of diagnosis.

Method

Retrospective, observational, population-based study conducted through a secondary analysis of the WOS Critical Care and Cancer Patient Database, which is a combined record of cancer, ICU, hospital discharge and mortality data. The analyses comprised all incident cases of adult lung cancer diagnosed between 2000 and 2009 in the WOS including those who were subsequently admitted to an ICU within two years of diagnosis. Multiple logistic regression was used to determine the factors associated with ICU, hospital and six-month survival for those admitted.

Results

26,731 incident cases of lung cancer were diagnosed during the study period with 398 patients admitted to an ICU within 2 years (1.49%). ICU, in-hospital and six-month survival were 58.5%, 42.0% and 31.2% respectively. Factors associated with increased survival were diagnoses in a large general hospital, admission under a surgical specialty, a curative treatment plan, female sex and previous chemotherapy whilst treatment with radiotherapy, surgical treatment 8 to 30 days prior to ICU, APACHE II score ≥ 28, receipt of mechanical ventilation or vasoactive agents were associated with reduced survival.

Conclusion

This is the first multi-centre UK study to assess the factors associated with survival in lung cancer patients admitted to intensive care. The findings could be important for clinicians in assisting decision making regarding the potential benefits ICU admission.