title: Causes of death of patients with lung cancer.
abstract: BACKGROUND
  The causes of death for patients with lung cancer are inadequately described.
  
  
  OBJECTIVE
  To categorize the immediate and contributing causes of death for patients with lung cancer.
  
  
  METHODS
  The autopsies from 100 patients who died of lung cancer between 1990 and February 2011 were analyzed.
  
  
  RESULTS
  Tumor burden was judged the immediate cause of death in 30 cases, including 26 cases of extensive metastases and 4 cases with wholly or primarily lung tumor burden (causing respiratory failure). Infection was the immediate cause of death for 20 patients, including 8 with sepsis and 12 with pneumonia. Complications of metastatic disease were the immediate causes of death in 18 cases, including 6 cases of hemopericardium from pericardial metastases, 3 from myocardial metastases, 3 from liver metastases, and 3 from brain metastases. Other immediate causes of death were pulmonary hemorrhage (12 cases), pulmonary embolism (10 cases, 2 tumor emboli), and pulmonary diffuse alveolar damage (7 cases). From a functional (pathophysiologic) perspective, respiratory failure could be regarded as the immediate cause of death (or mechanism of death) in 38 cases, usually because of a combination of lung conditions, including emphysema, airway obstruction, pneumonia, hemorrhage, embolism, resection, and lung injury in addition to the tumor. For 94 of the 100 patients, there were contributing causes of death, with an average of 2.5 contributing causes and up to 6 contributing causes of death.
  
  
  CONCLUSIONS
  The numerous and complex ways lung cancer kills patients pose a challenge for efforts to extend and improve their lives.
authors.affiliation: Department of Pathology, University of Pittsburgh Medical Center Presbyterian Hospital, Pittsburgh, Pennsylvania, USA. lnichol5@uthsc.edu
authors.forename: Larry
authors.initials: L
authors.lastname: Nichols
authors.forename: Rachel
authors.initials: R
authors.lastname: Saunders
authors.forename: Friedrich D
authors.initials: FD
authors.lastname: Knollmann
mesh_terms: D000046:Academic Medical Centers; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001344:Autopsy; D001932:Brain Neoplasms / Q000401:mortality / Q000556:secondary; D002423:Cause of Death; D057286:Electronic Health Records; D005260:Female; D006338:Heart Neoplasms / Q000401:mortality / Q000473:pathology / Q000556:secondary; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality / Q000556:secondary; D008175:Lung Neoplasms / Q000150:complications / Q000401:mortality* / Q000473:pathology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D010414:Pennsylvania / Q000453:epidemiology; D010490:Pericardial Effusion / Q000150:complications / Q000401:mortality; D010496:Pericardium / Q000473:pathology; D011014:Pneumonia / Q000150:complications / Q000401:mortality; D012131:Respiratory Insufficiency / Q000150:complications / Q000209:etiology / Q000401:mortality; D018805:Sepsis / Q000150:complications / Q000401:mortality; D047368:Tumor Burden