Introduction

Lung cancer is a common malignancy presenting to the ICU. We aim to analyse the outcomes of patients with lung cancer admitted to our ICU and identify factors associated with poor outcomes.

Methods

We conducted a retrospective analysis, collecting data on patient demographics, co-morbidities, lung cancer-related information, ICU interventions and mortality rates for patients with confirmed or presumptive lung cancer admitted to our ICU between 2018 and 2020. Severity of illness was assessed using the acute physiology and chronic health evaluation (APACHE) II and sequential organ failure assessment (SOFA) scores.

Results

There were 75 patients with lung cancer admitted to our ICU over the study period. 68% were male. 73.3% had metastatic/ extensive disease. Respiratory failure occurred in 79.0% of cases and 86.4% of admissions received mechanical ventilation for an average of 10.5 days. 74.1% required vasopressors. Mean admission APACHE and SOFA scores were 18.4 and 6.8, respectively. ICU and hospital mortality was 40.7% and 63%, respectively. Factors associated with ICU mortality included APACHE score (p = 0.018), SOFA score (p = 0.031), circulatory shock (p = 0.008), vasopressors use (p = 0.035) and duration of mechanical ventilation (p = 0.028).

Conclusion

While metastatic/ extensive disease was not associated with poorer outcomes in our study, ICU and hospital mortality for patients with lung cancer was very high, especially in the presence of the abovementioned factors. Pre-emptive discussions about goals of care should be done with the above considerations.