Predictors of hospitalization and short-term mortality among lung cancer patients in the emergency department

Aim: Lung cancer is one of the leading reasons for emergency department (ED) visits. In this study, we aimed to determine the reasons for ED visits and to identify predictive factors for hospitalization and short-term mortality (30-days mortality). Material and Methods: We conducted a retrospective, observational study on lung cancer patients admitted to ED of a tertiary hospital between 01 January 2018 and 01 January 2020. Patients' demographic data, main symptoms on admission, laboratory parameters, and radiological findings were recorded. Logistic regression analysis was employed to identify the predictive factors for hospitalization and short-term mortality. Results: A total of 200 lung cancer patients (174 males, 36 females, mean age 64 +/- 9.5 years) were included in the study. Respiratory symptoms (44.5%), clinical deterioration (23%), and pain (10.5%) were the most common main symptoms; 25% of patients had pneumonia on admission; 53% of patients were hospitalized and 4% of patients died in ED. Among the hospitalized patients, the length of stay in the hospital was 9.5 (1-56) days, during which 48 deaths (41.4%) were recorded. Among all patients, 41% died within 30 days after ED visits. In multivariate logistic regression, the presence of pneumonia was found to be a statistically significant predictive factor in both hospitalization (OR=5.420; 95%CI, 2.114 -13.898; p < 0.001) and short-term mortality. (OR=0.241; 95%CI, 0.109 - 0.534; p < 0.001). Discussion: The presence of pneumonia on admission is an important risk factor for hospitalization and short-term mortality. These relationships should be kept in mind for the careful management of lung cancer patients in ED.