Academic department of Anaesthesia, Critical Care and Pain, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK.
Department of Public Health, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK.
BMC Pulm Med. 2020 Feb 7;20(1):36. doi: 10.1186/s12890-020-1071-8.
Lung cancer is the most common cause of cancer related death worldwide and survival is poor. Patients with lung cancer may develop a critical illness, but it is unclear what features are associated with an Intensive Care Unit (ICU) admission.
This retrospective, observational, population-based study of linked cancer registration, ICU, hospital discharge and mortality data described the factors associated with ICU admission in patients with lung cancer. The cohort comprised all incident cases of adult lung cancer diagnosed between 1st January 2000 and 31st December 2009 in the West of Scotland, UK, who were subsequently admitted to an ICU within 2 years of cancer diagnosis. Multiple logistic regression was used to determine factors associated with admission.
26,731 incident cases of lung cancer were diagnosed with 398 (1.5%) patients admitted to an ICU. Patients were most commonly admitted with respiratory conditions and there was a high rate of invasive mechanical ventilation. ICU, in-hospital and six-month survival were 58.5, 42.0 and 31.2%, respectively. Surgical treatment of lung cancer increased the odds of ICU admission (OR 7.23 (5.14-10.2)). Odds of admission to ICU were reduced with older age (75-80 years OR 0.69 (0.49-0.94), > 80 years OR 0.21 (0.12-0.37)), female gender (OR 0.73 (0.59-0.90)) and radiotherapy (OR 0.54 (0.39-0.73)) or chemotherapy treatment (OR 0.52 (0.38-0.70)).
1.5% of patients diagnosed with lung cancer are admitted to an ICU but both short term and long term survival was poor. Factors associated with ICU admission included age < 75 years, male gender and surgical treatment of cancer.
肺癌是全球癌症相关死亡的最常见原因，患者生存状况较差。肺癌患者可能会发展为危重病，但目前尚不清楚哪些特征与重症监护病房（ICU）的收治有关。
本研究为回顾性、观察性、基于人群的研究，对癌症登记、ICU、住院和死亡率数据进行了链接，描述了与肺癌患者 ICU 收治相关的因素。队列包括英国苏格兰西部所有在 2000 年 1 月 1 日至 2009 年 12 月 31 日期间诊断为成人肺癌的新发病例，这些患者在癌症诊断后 2 年内被收治到 ICU。采用多因素逻辑回归确定与收治相关的因素。
共诊断出 26731 例肺癌病例，其中 398 例（1.5%）患者收治到 ICU。患者最常见的收治原因是呼吸系统疾病，且有较高的有创机械通气使用率。ICU、住院和 6 个月生存率分别为 58.5%、42.0%和 31.2%。肺癌的手术治疗增加了 ICU 收治的几率（比值比 7.23（5.14-10.2））。收治到 ICU 的几率随年龄的增加而降低（75-80 岁 OR 0.69（0.49-0.94），>80 岁 OR 0.21（0.12-0.37）），女性（OR 0.73（0.59-0.90））和放疗（OR 0.54（0.39-0.73））或化疗治疗（OR 0.52（0.38-0.70））。
1.5%的肺癌患者收治到 ICU，但短期和长期生存率均较差。与 ICU 收治相关的因素包括年龄<75 岁、男性和癌症的手术治疗。
