Admission of a patient with lung cancer to the intensive care unit (ICU) can be controversial because of the poor long-term survival for many of the patients. Roques et al identified factors associated with hospital and 6-month mortality that can help to decide if a particular patient should be admitted to the ICU. The authors are from the Hopital Tenon, Assistance Publique-Hopitaux de Paris and Universite Pierre et Marie Curie.


Patient selection: patient requiring critical care with a history of lung cancer, excluding someone who has just undergone pneumonectomy for lung cancer


Risk factors for hospital mortality and/or death within 6 months:

(1) ECOG scale >= 2

(2) acute respiratory failure requiring mechanical ventilation (or other respiratory support)

(3) cancer progression (uncontrolled disease, presumably metastatic)


A patient with none of these findings should derive benefit from the ICU admission. Since the odds ratios for each risk factor was around 4, a patient with 1 risk factors might be a candidate for admission if there were other favorable circumstances.


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