Özpınar Şeyda Nur, Gürün Kaya Aslıhan, Öz Miraç, Erol Serhat, Arslan Fatma, Çiledağ Aydın, Kaya Akın
Department of Chest Diseases, Ankara University Faculty of Medicine, Ankara, Türkiye.
Tuberk Toraks. 2023 Jun;71(2):138-147. doi: 10.5578/tt.20239917.
Prognosis of lung cancer patients followed in the intensive care unit: A cross-sectional study
Lung cancer is the most common solid organ malignancy requiring intensive care unit (ICU) admission. For many years, lung cancer patients were not considered in the priority patient category for admission to ICU because of their high mortality rate and poor response to therapy. Considering the developments in treatment modalities, we aimed to reevaluate the prognosis of patients with lung cancer in the ICU.
Patients characteristics, date of diagnosis, the reason for ICU admission, the stage of cancer, histopathological type, history of chemotherapy, radiotherapy, or surgery for cancer, and APACHE-II and Charlson comorbidity index (CCI) were recorded retrospectively
A total of 100 patients had a mean age of 69.7 ± 9.0 years. Among these patients, 18% had small cell lung cancer, while 82% had non-small cell lung cancer. The in-hospital mortality rate was 69% for all patients, while among those discharged from the ICU, the first 6-month mortality rate was 58.1%. The median survival time was 8.2 months. Advanced age, the need for mechanical ventilation, the need for vasopressors, a high APACHE -II, and the CCI all reduced survival in multivariate analysis, whereas chemotherapy and surgical history improved survival.
Patients admitted to the ICU with lung cancer continue to experience a high mortality rate. However, identifying the factors that are associated with survival can be crucial in establishing care plans and prioritizing ICU admission for further therapy.
重症监护病房中肺癌患者的预后：一项横断面研究
肺癌是最常见的需要入住重症监护病房（ICU）的实体器官恶性肿瘤。多年来，肺癌患者因其高死亡率和对治疗的不良反应而未被视为ICU优先收治的患者类别。鉴于治疗方式的发展，我们旨在重新评估ICU中肺癌患者的预后。
回顾性记录患者的特征、诊断日期、入住ICU的原因、癌症分期、组织病理学类型、癌症化疗、放疗或手术史，以及急性生理与慢性健康状况评分系统II（APACHE-II）和查尔森合并症指数（CCI）。
共有100例患者，平均年龄为69.7±9.0岁。在这些患者中，18%患有小细胞肺癌，而82%患有非小细胞肺癌。所有患者的院内死亡率为69%，而在从ICU出院的患者中，前6个月的死亡率为58.1%。中位生存时间为8.2个月。在多因素分析中，高龄、需要机械通气、需要血管升压药、高APACHE-II评分和CCI均降低了生存率，而化疗和手术史则提高了生存率。
入住ICU的肺癌患者死亡率仍然很高。然而，确定与生存相关的因素对于制定护理计划和确定ICU进一步治疗的收治优先级可能至关重要。
