One in 67 patients with lung cancer in Scotland requires admission to an intensive care unit (ICU) within two years of cancer diagnosis, suggests research carried out by the University of Glasgow.
The retrospective, observational, population-based study included all incident cases of adult lung cancer diagnosed between 1 January 2000 and 31 December 2009 in the West of Scotland, who were admitted to an ICU within 2 years of cancer diagnosis.
A total of 26,731 incident cases of lung cancer were diagnosed, with 398 (1.49%) patients admitted to an ICU. The most common reasons for ICU admission were respiratory conditions and there was a high rate of invasive mechanical ventilation.
Over half of those who were admitted survived to ICU discharge (58.5%), with nearly a third surviving to six months (31.2%).
Surgical treatment of lung cancer increased the odds of ICU admission (OR 7.23; 95% CI 5.14-10.2).
Odds of admission to ICU were reduced with older age (75-80 years OR 0.69; 95% CI 0.49-0.94, female gender (OR 0.73; 95% CI 0.59-0.90) and radiotherapy (OR 0.54; 95% CI 0.39-0.73) or chemotherapy (OR 0.52; 95% CI 0.38-0.70).
It was unclear why some factors that are usually associated with a better prognosis, such as younger age and surgical treatment, were associated with greater risks of ICU admission. The authors say this may represent physician decision-making and further prospective research is needed to explore the clinical pathways prior to ICU admission.
