Clinical Epidemiology and Ageing

Risk factors for early mortality of lung cancer patients in France: A nationwide analysis.

Goussault H, Gendarme S, Assié J-B, Jung C, Epaud S, Algans C, Salaün-Penquer N, Rousseau M, Lazatti A, Chouaid C Cancer Med. 2022;11(24):5025-5034.

BACKGROUND: Despite therapeutic advances, lung cancer remains the first cause of death from cancer. The main objective of this study was to identify risk factors associated with death within 3-months of the first hospitalization for lung cancer in France.

METHODS: This analysis included patients with a first hospitalization for lung cancer (between January 1, 2016 and December 31, 2018) according to diagnosis-related groups entered into the French national medical-administrative database. Clinical and socioeconomic parameters and characteristics of that first hospitalization were analyzed. A model predictive of early mortality was developed based on those variables.

RESULTS: The 144,087 included patients were 67% men; median age of 68 [interquartile range 60-76] years; 47% had metastatic disease at diagnosis; and 34% and 23%, respectively, had received systemic treatment or undergone curative surgery. The 3-month mortality was 19%, and significantly higher for those ≥70 versus <70 years old (OR 1.33, 1.22-1.45), men versus. women (OR 1.50, 1.44-1.55), those with metastatic disease at diagnosis (OR, 3.30, 3.18-3.43), first hospitalization via the emergency room (OR 1.65 1.59-1.71) and first hospitalization lasting >30 days (OR, 1.58 1.49-1.68). In contrast, no socioeconomic characteristic was associated with early mortality.

CONCLUSION: Almost 1 in 5 patients diagnosed with lung cancer in France died within 3 months post-diagnosis. Improving survival requires diagnosis at an earlier stage and better organization of diagnosis and specific care pathways.

MeSH terms: Aged; Databases, Factual; Female; France; Hospitalization; Humans; Lung Neoplasms; Male; Middle Aged; Risk Factors
DOI: 10.1002/cam4.4821