Survival predictors of lung cancer patients in ICU: the importance of acute kidney injury prediction and prevention.

Background: To identify potential predictors of short-term survival among patients with lung cancer admitted to the intensive care unit (ICU). Methods: A multicenter longitudinal observational study of patients with lung cancer was conducted between May 10, 2021 and July 10, 2021, at the ICUs of 37 cancer-specialty hospitals in China. This study included patients with a primary diagnosis of lung cancer who were admitted to the ICU for ≥24 h. Predictive factors for ICU outcomes, with 90-day survival as the major outcome, were explored using single and multivariate analyses. Results: A total of 269 patients were included in the final analysis. The 90-day mortality rate following ICU care was 45.4%. Patients with 90-day mortality exhibited more severe conditions before admission, a higher number of ICU-related complications, and underwent more intense treatment than survivors. Notably, despite the low recorded incidence, acute kidney injury (AKI) was independently associated with ICU, in-hospital, and 90-day mortality outcomes in the multivariate analysis. Furthermore, condition severity at admission and ICU treatment choices, especially anti-infection regimen, were identified as potential correlators of a higher AKI risk. Conclusion: AKI prediction and prevention may require prioritization in patients with lung cancer admitted in the ICU.