Outcomes and prognostic factors of patients with lung cancer and pneumonia-induced respiratory failure in a medical intensive care unit: A single-center study

• Published in: Journal of critical care 2014-06, Vol.29 (3), p.414-419
• Main Authors: Chang, Youjin, MD, Huh, Jin-Won, MD, Hong, Sang-Bum, MD, Lee, Dae Ho, MD, Suh, Cheolwon, MD, Kim, Sang-We, MD, Lim, Chae-Man, MD, Koh, Younsuck, MD
• Format: Article
• Language: English
• Subjects: Aged; Antibiotics; Cancer therapies; Cardiovascular disease; Chemotherapy; Confidence intervals; Critical Care; Critical Illness; Female; Hospitalization; Humans; Hydrogen-Ion Concentration; Intensive care; Intensive Care Units; Lung cancer; Lung diseases; Lung Neoplasms - blood; Lung Neoplasms - complications; Lung Neoplasms - mortality; Lung Neoplasms - radiotherapy; Male; Middle Aged; Mortality; Multivariate Analysis; Ostomy; Outcome; Outcome and Process Assessment (Health Care); Patients; Pneumonia; Pneumonia - blood; Pneumonia - complications; Pneumonia - mortality; Prognosis; Radiation therapy; Respiratory failure; Respiratory Insufficiency - blood; Respiratory Insufficiency - etiology; Respiratory Insufficiency - mortality; Retrospective Studies; Time Factors
• ISSN: 0883-9441; 1557-8615
• DOI: 10.1016/j.jcrc.2014.01.005

Abstract Purpose To evaluate the outcomes and prognostic factors of 28-day mortality following medical intensive care unit (MICU) admission of patients with lung cancer and pneumonia-induced respiratory failure. Materials and methods Patients admitted to the MICU of a tertiary referral hospital between 2000 and 2009 were retrospectively studied. Results In total, 143 patients were included. Their mean age was 65 ± 8 years and 94% were male. The 28-day mortality rate was 57%. Multivariate analysis was performed to identify variables associated with 28-day mortality. At 72 hours after admission, a history of radiotherapy (OR = 2.80, 95% CI: 1.15-6.78), Pa o2 /F io2 (P/F) ratio at admission of < 100 mmHg (OR = 5.62, 95% CI: 2.10-15.07), P/F ratio after 72 hours of < 100 mmHg (OR = 4.61, 95% CI: 1.24-17.15), and arterial pH after 72 hours of < 7.30 (OR = 5.78, 95% CI: 1.15-28.89) were associated with increased mortality. Conclusions The prognosis of patients with lung cancer and severe pneumonia after 72 hours of MICU management mainly depends on the severity of the underlying lung injury, which is reflected by a history of radiotherapy and a low P/F ratio, rather than on cancer stage or disease status.