1599P - Clinical predictors of 30-day mortality in hospitalized patients with lung cancer: A retrospective single-center observational study

Background

Lung cancer patients experience high rates of hospitalization, mainly due to the high risk of complications that emerge during the natural history of disease. We designed a retrospective single-center observational study aimed at defining clinical predictors of 30-day mortality in hospitalized lung cancer patients.

Methods

Clinical records from the first admission of lung cancer patients to the Oncology ward of University Hospital of Parma from January 1^st, 2017, to January 1^st, 2022, were collected.

Results

251 patients were consecutively enrolled. Median age was 66 years (Range, 29-85). 161 (64.1%) patients were men and 217 (86.5%) current/former smokers. ECOG PS was 0-1 in 182 (72.5%) cases. The most frequent histology was adenocarcinoma (n=120, 47.8%), followed by small-cell carcinoma (n=73, 29.0%), and the majority of patients had stage IV disease (n=209, 83.3%). Main reasons for hospital admission were anticancer treatment start (n=146, 58.2%) and cancer-related complications (n=75, 29.9%). The most frequently symptoms at admission were pain (n=131, 52.2%) and dyspnea (n=92, 36.7%). Median Blaylock Risk Assessment Screening Score (BRASS) was 7 (Range, 1-28). Clinical deterioration (n=102, 40.6%) was the main complication during the hospital stay. Baseline clinical predictors of 30-day mortality were poor ECOG PS (≥ 2 vs 0-1: 27.5% vs 14.8%, p=0.028), high BRASS (High vs Intermediate-Low: 34.3% vs 11.9%, p<0.001), high number of metastatic sites (≥ 3 vs < 3: 26.5% vs 13.4%, p=0.017), presence of bone metastases (Yes vs No: 29.0% vs 10.8%, p=0.001) and presence of pain (Yes vs No: 24.4% vs 11.7%, p=0.009). At multivariate analysis, only high BRASS remained significantly associated with higher 30-day mortality (BRASS High vs Intermediate-Low Odds Ratio 2.87, 95% CI 1.21-6.78, p=0.016).

Conclusions

Baseline poor ECOG PS, high BRASS, high tumour burden, presence bone metastases and pain were associated with increased 30-day mortality in hospitalized lung cancer patients, with high BRASS being statistically significant at multivariate analysis. Our study draw attention on BRASS as a new feasible potential indicator of 30-day mortality in hospitalized lung cancer patients.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

University Hospital of Parma.

Funding

Has not received any funding.

Disclosure

A. Leonetti: Financial Interests, Personal, Invited Speaker: AstraZeneca, MSD, Takeda; Financial Interests, Personal, Advisory Board: Sanofi, BeiGene, Novartis. P. Bordi: Financial Interests, Personal, Advisory Board: Boehringer Ingelheim; Financial Interests, Personal, Invited Speaker: AstraZeneca, Takeda. S. Buti: Financial Interests, Personal, Advisory Board: BMS, Pfizer, MSD, Ipsen, AstraZeneca, Novartis; Financial Interests, Personal, Invited Speaker: BMS, MSD, Ipsen, AstraZeneca, Novartis; Financial Interests, Personal, Expert Testimony: MSD, Pierre-Fabre; Financial Interests, Institutional, Invited Speaker: BMS, BMS, Ipsen, AstraZeneca, MSD; Financial Interests, Institutional, Research Grant: Novartis; Non-Financial Interests, Other, Member of panel for kidney cancer guidelines: AIOM (Italian Association of Medical Oncology); Non-Financial Interests, Other, member and coordinator of the “Rare Tumors” group: Meet-URO group (Italian Network For Research In Urologic-Oncology). M. Tiseo: Financial Interests, Personal, Research Grant: AstraZeneca, BI; Financial Interests, Personal, Other: Amgen; Financial Interests, Personal, Advisory Role: AstraZeneca, MSD, Pfizer, Eli Lilly, Roche, BMS, Amgen, Sanofi, Merck, BI, Takeda, Novartis. All other authors have declared no conflicts of interest.