(1248) Lung Cancer Patients Admitted to the Intensive Care Unit: A Systematic Review and Meta-Analysis

Tuesday, February 25, 2025

12:30pm – 1:30pm Eastern Time

Location: Connections Central - RST 15

First Author(s)

PD

Prashil Dave, MD

Resident physician
SUNY Downstate Health Sciences University
Brooklyn, New York, United States

Co-Author(s)

DS

Dipsa Shastri, MD

Resident physician
East Tennessee State University, United States
AS

Ankur Singla, MD

Resident Physician
Department of Internal Medicine, Northwest Health-Porter, Valparaiso, IN, United States
YO

Yakubu Aliu Opeyemi, N/A

Resident physician
University Hospital Wishaw, United States
SI

Sohaib Irfan, MD

Medical graduate
Aga Khan University, United States
AU

Anwar Uddin, MD

Resident physician
SUNY Downstate Health Sciences University, United States
DP

Debolina Pramanik, MD

Resident physician
Medical College Kolkata, United States
MK

Mousumi Khanam, MD

Medical graduate
Dhaka Medical College, United States

Introduction: Underlying comorbidities or malignancy-related complications make intensive care unit (ICU) admissions for lung cancer patients fairly common and challenging. This meta-analysis investigates original studies on survival, mortality, and outcomes for lung cancer patients admitted to the ICU.

Methods: PRISMA guidelines were followed, and PubMed, Cochrane, and Google Scholar search was conducted using MeSH terms from January 2004 to December 2023. All included patients were aged 18 years or older, with the majority presenting with stage III or higher non-small cell or small cell lung cancer. The inter-study variance was calculated using the Der Simonian-Laird Estimator. Proportions and a 95% confidence Interval (CI) were extracted to compute pooled analysis using the 'meta' package by Schwarzer et al. in the R programming language (version 4.3.3).

Results: A total of 185822 patients from 21 studies were included. Twenty were retrospective studies, and one was a prospective study. The median age of the included patients was 67.2 years, and 38.6% % (71712/185822) were male. The median overall survival was 77 days. The pooled medical intensive care unit survivor rate was 50% (n=2595, 95% CI 0.41-0.59, I2=94%, p< 0.01). The pooled smoking rate among these lung cancer patients was 82% (n=1141, 95% CI 0.71-0.89, I2=92%, p< 0.01). The pooled ventilator use rate was 69% (n=184688, 95% CI 0.53-0.82, I2=100%, p=0), while the pooled vasopressor use rate among these patients was 46% (n=22130, 95% CI 0.33-0.59, I2=96%, p< 0.01). The pooled ICU mortality rate was 38% (n=98675, 95% CI 0.31-0.45, I2=100%, p=0), and the 1-year mortality rate was 44% (n=183788, 95% CI 0.12-0.82, I2=100%, p=0). The most common nonlung cancer-related reason for admission was infection (reported in 11/21 studies). The most common lung cancer-related reason for admission was pleural effusion (reported in 3/21 studies).

Conclusions: Our analysis highlights the suboptimal outcomes for lung cancer patients despite the increased utilization of intensive care unit management strategies. Further randomized controlled trials and prospective studies are essential to establish evidence-based guidelines that can improve survival outcomes and overall quality of care for lung cancer patients in critical care settings.