Intensive care in patients with lung cancer : a multinational study
Almeida, B F C
Silva, U V A
Azevedo, L C P
Souza-Dantas, V C
Salluh, J I F
Lung Cancer in Critical Care (LUCCA) Study Investigators
BACKGROUND: Detailed information about lung cancer patients requiring admission to intensive care units (ICUs) is mostly restricted to single-center studies. Our aim was to evaluate the clinical characteristics and outcomes of lung cancer patients admitted to ICUs. PATIENTS AND METHODS: Prospective multicenter study in 449 patients with lung cancer (small cell, n = 55; non-small cell, n = 394) admitted to 22 ICUs in six countries in Europe and South America during 2011. Multivariate Cox proportional hazards frailty models were built to identify characteristics associated with 30-day and 6-month mortality. RESULTS: Most of the patients (71%) had newly diagnosed cancer. Cancer-related complications occurred in 56% of patients; the most common was tumoral airway involvement (26%). Ventilatory support was required in 53% of patients. Overall hospital, 30-day, and 6-month mortality rates were 39%, 41%, and 55%, respectively. After adjustment for type of admission and early treatment-limitation decisions, determinants of mortality were organ dysfunction severity, poor performance status (PS), recurrent/progressive cancer, and cancer-related complications. Mortality rates were far lower in the patient subset with nonrecurrent/progressive cancer and a good PS, even those with sepsis, multiple organ dysfunctions, and need for ventilatory support. Mortality was also lower in high-volume centers. Poor PS predicted failure to receive the initially planned cancer treatment after hospital discharge. CONCLUSIONS: ICU admission was associated with meaningful survival in lung cancer patients with good PS and non-recurrent/progressive disease. Conversely, mortality rates were very high in patients not fit for anticancer treatment and poor PS. In this subgroup, palliative care may be the best option.
Published inAnnals of Oncology
MetadataShow full item record
Showing items related by title, author, creator and subject.
Reconsidering the Gospel According to Group Studies: A Neuropsychological Case Study Approach to Schizophrenia Laws, K.R.; McKenna, P. J.; McCarthy, R.A. (1996)Individual patterns of performance on tests of: visual perception, language, executive function, memory, and face-processing, were examined in 10 schizophrenic patients who were preselected for having current WAIS IQ and ...
Nanocrystalline diamond as an electronic material : an impedance spectroscopic study and Hall effect measurement study Bevilacqua, Mose; Tumilty, Niall; Mitra, Chiranjib; Ye, Haitao; Feygelson, Tatayana; Butler, James E.; Jackman, Richard B. (2010)Nanocrystalline diamond (NCD) has been grown using a nanodiamond seeding technique, leading to a dense form of this material, with grain sizes around 100 nm. The electrical properties of both intrinsic and lightly boron-doped ...
Halliday, Sue (Pearson Education, 2005)‘The future is bright, the future is orange’ sounds text perplexing without any context. Audiences in older age brackets around the world certainly find it strange. These people would probably not have a mobile and would ...