Predictive factors of death in primary lung cancer patients on admission to the intensive care unit

Objective: To assess the lung cancer patient's prognosis in the intensive c are unit with early predictive factors of death. Design. Retrospective study from July 1986 to February 1996. Setting: Medical intensive care unit at a university hospital. Patients: Fifty-seven patients with primary lung cancer admitted to our med ical intensive care unit (MICU). Measurements and results: Data collection included demographic data (age, s ex, underlying diseases, MICU admitting diagnosis) and evaluation of tumor (pathologic subtypes, metastases, lung cancer staging, treatment options). Three indexes were calculated for each patient: Karnofsky performance statu s, Simplified Acute Physiology Score (SAPS) II, and multisystem organ failu re score (ODIN score). Mortality was high in the MICU: 66% of patients died during their MICU stay, and hospital mortality reached 75%. In multivariat e analysis, acute pulmonary disease and Karnofsky performance status < 70 w ere associated with a poor MICU and post-MICU prognosis. For the survivors, long-term survival after MICU discharge depended exclusively on the severi ty of the lung cancer. Conclusions: We confirmed the high mortality rate of lung cancer patients a dmitted to the MICU. Two predictive factors of death in MICU were identifie d: performance status < 70 and acute pulmonary disease.