title: Analysis of advanced lung cancer patients diagnosed following emergency admission.
abstract: Data on prognosis and predictors of overall survival in advanced lung cancer patients diagnosed following emergency admission (DFEA) are currently lacking. We retrospectively analysed data from 771 patients with advanced nonsmall cell lung cancer between April 2004 and April 2012. Of the 771 patients, 103 (13%) were DFEA. DFEA was not an independent predictor of overall survival by multivariate Cox proportional hazard models, whereas good performance status (PS), epidermal growth factor receptor gene mutation, stage IIIB, adenocarcinoma and chemotherapy were independent predictors of overall survival (hazard ratio (95% CI) 0.36 (0.29-0.44), p<0.001; 0.49 (0.38-0.63), p<0.001; 0.64 (0.51-0.80), p<0.001; 0.81 (0.67-0.99), p=0.044; and 0.40 (0.31-0.52), p<0.001, respectively). Good PS just prior to opting for chemotherapy, but not at emergency admission, was a good independent predictor of overall survival in DFEA patients (hazard ratio (95% CI) 0.26 (0.12-0.55); p<0.001). DFEA is relatively common. DFEA and PS at emergency admission were not independent predictors of overall survival, but good PS just prior to opting for chemotherapy was an independent predictor of longer overall survival. Efforts to improve patient PS after admission should be considered vital in such circumstances.
authors.affiliation: Dept of Respiratory Medicine, Kobe City Medical Center General Hospital, Kobe, Japan.
authors.forename: Daichi
authors.initials: D
authors.lastname: Fujimoto
authors.affiliation: Dept of Respiratory Medicine, Kobe City Medical Center General Hospital, Kobe, Japan.
authors.forename: Ryoko
authors.initials: R
authors.lastname: Shimizu
authors.affiliation: Clinical Research Center, Kobe City Medical Center General Hospital, Kobe, Japan Division of General Internal Medicine, Hyogo College of Medicine, Nishinomiya, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Morimoto
authors.affiliation: Dept of Respiratory Medicine, Kobe City Medical Center General Hospital, Kobe, Japan.
authors.forename: Ryoji
authors.initials: R
authors.lastname: Kato
authors.affiliation: Dept of Respiratory Medicine, Kobe City Medical Center General Hospital, Kobe, Japan.
authors.forename: Yuki
authors.initials: Y
authors.lastname: Sato
authors.affiliation: Dept of Respiratory Medicine, Kobe City Medical Center General Hospital, Kobe, Japan.
authors.forename: Mariko
authors.initials: M
authors.lastname: Kogo
authors.affiliation: Dept of Respiratory Medicine, Kobe City Medical Center General Hospital, Kobe, Japan.
authors.forename: Jiro
authors.initials: J
authors.lastname: Ito
authors.affiliation: Dept of Respiratory Medicine, Kobe City Medical Center General Hospital, Kobe, Japan.
authors.forename: Shunsuke
authors.initials: S
authors.lastname: Teraoka
authors.affiliation: Dept of Respiratory Medicine, Kobe City Medical Center General Hospital, Kobe, Japan.
authors.forename: Takehiro
authors.initials: T
authors.lastname: Otoshi
authors.affiliation: Dept of Respiratory Medicine, Kobe City Medical Center General Hospital, Kobe, Japan.
authors.forename: Kazuma
authors.initials: K
authors.lastname: Nagata
authors.affiliation: Dept of Respiratory Medicine, Kobe City Medical Center General Hospital, Kobe, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Nakagawa
authors.affiliation: Dept of Respiratory Medicine, Kobe City Medical Center General Hospital, Kobe, Japan.
authors.forename: Kojiro
authors.initials: K
authors.lastname: Otsuka
authors.affiliation: Dept of Respiratory Medicine, Kobe City Medical Center General Hospital, Kobe, Japan.
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Katakami
authors.affiliation: Dept of Respiratory Medicine, Kobe City Medical Center General Hospital, Kobe, Japan.
authors.forename: Keisuke
authors.initials: K
authors.lastname: Tomii
mesh_terms: D000368:Aged; D001707:Biopsy, Needle; D002289:Carcinoma, Non-Small-Cell Lung / Q000175:diagnosis* / Q000453:epidemiology* / Q000628:therapy; D016208:Databases, Factual; D004636:Emergency Service, Hospital; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007150:Immunohistochemistry; D007564:Japan; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000453:epidemiology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009361:Neoplasm Invasiveness / Q000473:pathology; D009367:Neoplasm Staging; D010343:Patient Admission / Q000706:statistics & numerical data; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D018570:Risk Assessment; D016019:Survival Analysis; D016896:Treatment Outcome