- 作者：Marcelo R. Bonomi ; Cardinale B. Smith ; Grace Mhango ; Juan P. Wisnivesky
- 关键词：Elderly ; Intensive care unit ; Lung cancer ; Mortality
- 刊名：Lung Cancer
- 出版年：2012
- 出版时间：September, 2012
- 年：2012
- 卷：77
- 期：3
- 页码：600-604
- 全文大小：186 K
Background
Although the prognosis of elderly patients with stage IIIB and IV non-small cell lung cancer (NSCLC) is poor, it remains a common cause of cancer related admissions to the intensive care unit (ICU). The objective was to evaluate short and long-term outcomes of a population-based sample of elderly patients with advanced NSCLC who require ICU care.Methods
Using combined data from the Surveillance, Epidemiology and End Results registry and Medicare files, we identified 1134 patients >65 years of age with stage IIIB and IV NSCLC admitted to an ICU with a diagnosis of respiratory, cardiac, or neurologic complications, renal failure, or sepsis. We assessed rates and predictors of death during hospitalization. The Kaplan-Meier method was used to estimate mortality rates at 90 days and 1 year post hospital discharge.
Results
In-hospital mortality was 33 % (95 % CI: 30-36 % ). The 90-day and 1-year mortality rate was 71 % and 90 % , respectively. Patients with an admitting diagnosis of sepsis had the highest rate of in-hospital mortality (59 % ). Of those who were alive at discharge, 52 % were transferred to a skilled nursing facility, 6 % to hospice, and 42 % returned home.
Conclusion
We found that one-third of elderly patients with advanced NSCLC admitted to the ICU do not survive hospitalization. Among survivors, most patients required continued institutionalization with a very low likelihood of surviving >1 year from discharge. This data should help patients, families, and health care providers of elderly patients with advanced NSCLC make decisions regarding ICU utilization.