Inflammation related parameters in lung cancer patients followed in the intensive care unit
Burcu Tunay, Ömer Fatih Ölmez, Ahmet Bilici, Ayberk Bayramgil, Güneş Dorukhan Çavuşoğlu, Hüseyin Öz
Istanbul Medipol University School of Medicine Department of Anesthesiology and Reanimation
Giriş: Lung cancer remains as the most common cause of cancer-related death. Despite extensive research, the possible relationships between various inflammatory markers and lung cancer prognosis are yet to be clarified. In this study, we aimed to assess and compare various inflammatory markers and prognostic tests for their role in predicting mortality in patients with lung cancer who were admitted to the intensive care unit for any reason.
Gereç ve Yöntem: This retrospective cohort was conducted between 2014 and 2020 at the Medical Oncology Department and Intensive Care Unit, Medipol University Faculty of Medicine, Istanbul, Turkey. A total of 229 patients diagnosed with small cell or non-small cell lung cancer who attended follow-up after treatment were included.The predictive performance of neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), systemic immune-inflammation index (SII), modified Glasgow prognostic score (mGPS), Prognostic nutritional index (PNI), APACHE II score, MPM II-Admission (Mortality Probability Models II-0) were assessed in terms of mortality status. We also performed multivariable logistic regression to determine whether any of these parameters were independently associated with mortality.
Bulgular: We included 229 patients (163 males and 66 females) into our study, mean age was 66.17 ± 11.89 (range 22 - 92) years. Among these, 135 (58.95%) patients died (exitus) and 94 (41.05%) patients were discharged. When we evaluated performance of the prognostic scores to predict mortality, we found mGPS, MPM II-Admission and APACHE II score had the highest sensitivity, and MPM II-Admission, PNI and APACHE II score had the highest specificity. Multivariable regression revealed that PNI was the only parameter that was independently associated with mortality.
Tartışma ve Sonuç: PNI, APACHE-II, and MPM II-Admission may be used as easily accessible tests for mortality estimation in lung cancer patients admitted to the ICU. However, it appears that NLR, PLR, LMR, and SII are unassociated with mortality in this group of patients.
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