Chest
Original Research: Neoplastic DiseasesPrognosis of Lung Cancer Patients With Life-Threatening Complications
Section snippets
Design and Setting
This cohort study was performed at the ICUs of the Instituto Nacional de Câncer (INCA), Rio de Janeiro, Brazil, and of the Hôpital Saint-Louis, Université Paris 7, Assistance Publique, Hôpitaux de Paris, France. The INCA is a 200-bed teaching hospital for patients with cancer. Its ICU is a 10-bed medical-surgical unit. The Hôpital Saint-Louis is a 650-bed hospital with 330 beds in hematology and oncology wards and a 12-bed medical ICU. The organization and admission policies of both ICUs have
Patient Characteristics
The study included 152 patients: 98 patients (64%) from INCA and 54 patients (36%) from Hôpital Saint-Louis. Nine patients from Hôpital Saint-Louis were excluded due to missing data, leaving 143 patients for the study. Baseline patient characteristics were similar in the two institutions (Table 1). The main reasons for ICU admission are depicted inTable 2. Infection was present at ICU admission in 86 patients (60%), with the main categories being community-acquired pneumonia (n = 46, 53%),
Discussion
Many patients with lung cancer require admission to the ICU during the course of the disease. That ICU admission is beneficial in the postoperative period after pulmonary resection for lung cancer is well established. However, when acute life-threatening complications develop, most notably ARF, oncologists and intensivists are often doubtful about the wisdom of ICU admission. ARF in these patients is usually considered a consequence of advanced disease that is not responsive to supportive care.
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This work was performed at the ICUs of the INCA, Rio de Janeiro, Brazil, and Saint Louis University Hospital-Paris 7 University, Assistance Publique, Hôpitaux de Paris, France.
Preliminary data were presented as a poster at the Nineteenth Annual Meeting of the European Society of Intensive Care Medicine, Barcelona, Spain, September 24–27, 2006.
Financial support was provided by institutional funds.
The authors have no financial or other potential conflicts of interest exist.
Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (www.chestjournal.org/misc/reprints.shtml).