Patients diagnosed with bronchogenic carcinoma are increasingly getting admitted to the medical intensive care units (ICU). Epidemiology and outcome of these patients is not well delineated in medical literature. The aim of our study was to investigate the outcome of these patients and to examine the predictors of mortality.
Retrospective study of all patients admitted to the ICUs at the 2 local tertiary care university hospitals in Winnipeg, from May 30, 1999 to July 31, 2003. A computerized search of the database identified 28 patients who were admitted with a previously known or a new diagnosis of primary lung cancer. 11 patients were excluded for non-primary lung cancer diagnoses (lymphoma, metastatic rectal carcinoma, bronchiectasis, and bronchiolitis obliterans). A total of 17 patients were included in this study. Data on demographics (age, sex, geographic data, admitting diagnosis, length of stay, outcome, treatment, TISS and APACHE II day 1 scores, admission bloodwork, co-morbid diseases and cancer related data (histology, metastases, staging, treatment options) were extracted.
47% of the 17 patients were female; the median age was 64 (42 -81). 29.4% were small cell lung cancer (SCLC), 52.9% were non-small cell lung cancer (NSCLC) and 17.7% of unknown type. The mean ICU length of stay was 5.5 days (0 –16 days) and the mean ICU mortality rate was 47.1%. Mean hospital length of stay 15.7 days (1 –53 days) and mean hospital mortality rate 52.9%. A small number (5.8%) were transferred to the palliative care unit.
Patients admitted to ICU with previously or newly diagnosed primary lung cancer has high mortality rates. However, their outcome is similar to the patients admitted with other common ICU diagnoses such as pneumonia and septic shock. A successful discharge from the ICU was associated with a successful discharge from the hospital.
Patients with a new or a previous diagnosis of primary lung cancer have favourable prognosis when admitted to an intensive care unit with a life threatening problem.
J.M. Maniate, None.