Format

Send to

Choose Destination
Ann Intensive Care. 2018 Aug 4;8(1):80. doi: 10.1186/s13613-018-0426-2.

Characteristics and outcome of patients with newly diagnosed advanced or metastatic lung cancer admitted to intensive care units (ICUs).

Author information

1
Medical ICU, AP-HP, Hôpital Saint-Louis, 1 Avenue Claude Vellefaux, 75010, Paris, France.
2
Post-Graduation Program, Instituto Nacional de Câncer, Rio de Janeiro Department of Clinical Research, D'Or Institute for Research and Education, Rio de Janeiro, Brazil.
3
Inserm, u 823, Institut A Bonniot, Grenoble, France.
4
Medical ICU, Hôpital Bichat-Claude Bernard, Paris, France.
5
ICU, Hospital Maciel, Montevideo, Uruguay.
6
ICU, Instituto Medico Especializado Alexander Fleming, Buenos Aires, Argentina.
7
ICU, Royal Brompton NHS Foundation Trust, London ICU, Royal Marsden Hospital, London, UK.
8
ICU, Hospital Clinico Universidad de Chile, Santiago, Chile.
9
ICU, Hospital A. C. Camargo, São Paulo, Brazil.
10
ICU, Fundação Pio XII-Hospital do Câncer de Barretos, Barretos, Brazil.
11
ICU, Hospital Sírio Libanês, São Paulo, Brazil.
12
Thoracic ICU, Hôpital Cochin, Paris, France.
13
ICU, Institut Mutualiste Montsouris, Paris, France.
14
Medical ICU, Hôpital Tenon, Paris, France.
15
ICU, Instituto Nacional de Câncer-Hospital do Câncer I, Rio de Janeiro, Brazil.
16
Medical-Surgical ICU, Hospices Civils de Lyon Centre Hospitalier Lyon Sud, Lyon, France.
17
ICU, Institut Gustave Roussy, Villejuif, France.
18
Medical ICU, Hôpital de la Croix-Rousse, Lyon, France.
19
ICU, Vitória Apart Hospital, Vitória, Brazil.
20
Medical ICU, Groupe Hospitalier Pitié Salpêtrière, Paris, France.
21
Surgical ICU, Hôpital A. Michallon Chu de Grenoble, Grenoble, France.
22
Medical ICU, AP-HP, Hôpital Saint-Louis, 1 Avenue Claude Vellefaux, 75010, Paris, France. virginie.lemiale@aphp.fr.

Abstract

BACKGROUND:

Although patients with advanced or metastatic lung cancer have poor prognosis, admission to the ICU for management of life-threatening complications has increased over the years. Patients with newly diagnosed lung cancer appear as good candidates for ICU admission, but more robust information to assist decisions is lacking. The aim of our study was to evaluate the prognosis of newly diagnosed unresectable lung cancer patients.

METHODS:

A retrospective multicentric study analyzed the outcome of patients admitted to the ICU with a newly diagnosed lung cancer (diagnosis within the month) between 2010 and 2013.

RESULTS:

Out of the 100 patients, 30 had small cell lung cancer (SCLC) and 70 had non-small cell lung cancer. (Thirty patients had already been treated with oncologic treatments.) Mechanical ventilation (MV) was performed for 81 patients. Seventeen patients received emergency chemotherapy during their ICU stay. ICU, hospital, 3- and 6-month mortality were, respectively, 47, 60, 67 and 71%. Hospital mortality was 60% when invasive MV was used alone, 71% when MV and vasopressors were needed and 83% when MV, vasopressors and hemodialysis were required. In multivariate analysis, hospital mortality was associated with metastatic disease (OR 4.22 [1.4-12.4]; p = 0.008), need for invasive MV (OR 4.20 [1.11-16.2]; p = 0.030), while chemotherapy in ICU was associated with survival (OR 0.23, [0.07-0.81]; p = 0.020).

CONCLUSION:

This study shows that ICU management can be appropriate for selected newly diagnosed patients with advanced lung cancer, and chemotherapy might improve outcome for patients with SCLC admitted for cancer-related complications. Nevertheless, tumors' characteristics, numbers and types of organ dysfunction should be taken into account in the decisional process before admitting these patients in ICU.

KEYWORDS:

Chemotherapy; Intensive care; Lung cancer; Metastatic; Outcome

Supplemental Content

Full text links

Icon for Springer Icon for PubMed Central
Loading ...
Support Center