重症监护病房肺癌患者的生存预测因素：急性肾损伤预测与预防的重要性。

Survival predictors of lung cancer patients in ICU: the importance of acute kidney injury prediction and prevention.

作者信息

Shen Jue, Wang Changsong, Ma Gang, Wang Hong-Zhi, Xing Xuezhong, Zhu Biao, Zhao Jianghong, Wang Donghao, Cui Mingou

机构信息

Department of Intensive Care Unit, Zhejiang Cancer Hospital, Hangzhou Institute of Medicine (HIM), Chinese Academy of Sciences, Hangzhou, China.

Department of Intensive Care Unit, Harbin Medical University Cancer Hospital, Harbin, China.

出版信息

PeerJ. 2025 Aug 29;13:e19885. doi: 10.7717/peerj.19885. eCollection 2025.

DOI:10.7717/peerj.19885

PMID:40900749

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12401016/

Abstract

BACKGROUND

To identify potential predictors of short-term survival among patients with lung cancer admitted to the intensive care unit (ICU).

METHODS

A multicenter longitudinal observational study of patients with lung cancer was conducted between May 10, 2021 and July 10, 2021, at the ICUs of 37 cancer-specialty hospitals in China. This study included patients with a primary diagnosis of lung cancer who were admitted to the ICU for ≥24 h. Predictive factors for ICU outcomes, with 90-day survival as the major outcome, were explored using single and multivariate analyses.

RESULTS

A total of 269 patients were included in the final analysis. The 90-day mortality rate following ICU care was 45.4%. Patients with 90-day mortality exhibited more severe conditions before admission, a higher number of ICU-related complications, and underwent more intense treatment than survivors. Notably, despite the low recorded incidence, acute kidney injury (AKI) was independently associated with ICU, in-hospital, and 90-day mortality outcomes in the multivariate analysis. Furthermore, condition severity at admission and ICU treatment choices, especially anti-infection regimen, were identified as potential correlators of a higher AKI risk.

CONCLUSION

AKI prediction and prevention may require prioritization in patients with lung cancer admitted in the ICU.

摘要

背景

确定入住重症监护病房（ICU）的肺癌患者短期生存的潜在预测因素。

方法

2021年5月10日至2021年7月10日期间，在中国37家肿瘤专科医院的ICU对肺癌患者进行了一项多中心纵向观察性研究。本研究纳入了初次诊断为肺癌且入住ICU≥24小时的患者。以90天生存率为主要结局，采用单因素和多因素分析探讨ICU结局的预测因素。

结果

最终分析共纳入269例患者。ICU治疗后的90天死亡率为45.4%。与幸存者相比，90天死亡率患者入院前病情更严重，ICU相关并发症更多，接受的治疗更 intensive 。值得注意的是，尽管记录的发病率较低，但在多因素分析中，急性肾损伤（AKI）与ICU、住院和90天死亡率结局独立相关。此外，入院时的病情严重程度和ICU治疗选择，尤其是抗感染方案，被确定为AKI风险较高的潜在相关因素。