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Master Thesis

Prise en charge en réanimation de patients porteurs d'un cancer bronchique non résécable‎

Abstract : Background: Admission of lung cancer patients to the intensive care unit (ICU) has been criticized. We evaluated whether ICU admission improved 3-month survival in patients with nonresectable lung cancer. Factors associated with survival were identified. Methods: Retrospective study in consecutive non-surgical lung cancer patients admitted to three ICUs in France (2000-2007, 2005-2007, and 2005-2006, respectively). Results: We included 103 patients with a median [Q1-Q3] SAPS II of 33 [25-46] and a median LOD of 3 [1-4]. Invasive mechanical ventilation was required in 41 (40%) patients. Sixty-three (61%) patients had metastasis and 26 (25%) an ECOG performance status (PS) >2. The reason for ICU admission was acute respiratory failure in 58 (56%) patients. Three-month survival rate was 37% (95% confidence interval [95% CI], 28-46). By multivariate analysis, variables associated with mortality were ECOG-PS >2 (hazard ratio [HR], 2.65; 95% CI, 1.43-4.88), metastasis at admission (HR, 1.90; 95% CI, 1.08-3.33), and worse LOD score (HR, 1.19; 95% CI, 1.08-1.32). The LOD score decrease over the first 72 hours was associated with survival. Conclusions: Survival in patients with non-surgical lung cancer requiring ICU admission was 37% after 90 days. Our results provide additional evidence that ICU management may be appropriate in patients with nonresectable lung cancer and organ failures.
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Master Thesis
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Submitted on : Friday, September 30, 2011 - 2:38:19 PM
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  • HAL Id : dumas-00628122, version 1

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Anne-Claire Toffart. Prise en charge en réanimation de patients porteurs d'un cancer bronchique non résécable‎. Médecine humaine et pathologie. 2010. ⟨dumas-00628122⟩

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