Age can be a predictor for in-hospital mortality (IHM) and length of hospital stay (LOS) in lung cancer

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Introduction: Lung, colon and breast cancer account for 46% of all cancer related mortality in both sexes. Unlike lung cancer, patients diagnosed with breast and colon cancer ≤40 years old have poor prognosis compared to their counter parts diagnosed at ≥ 40. Limited data are available on the predictors of in-hospital mortality (IHM) and length of hospital stay (LOS) with respect to the primary diagnosis of these cancers. Among advanced cancer diseases, patients with lung cancer underwent in-patient hospital treatment most frequently (3.3 times), and for the longest periods (35 days). We evaluated to see if age >45 is a predictor for IHM and LOS in the primary diagnosis of lung cancer.
 Methods: Details about the in-hospital statistics including the admission and discharge statistics was obtained from Healthcare Cost and Utilization Project (HCUPnet) for the period 1997-2003. These data were broken down by age ≤ 44 and >45; and by anatomic location. Chi- square analysis was performed to compare the IHM and T-test was used to compare the LOS. Values are expressed as X ± SE or odds ratio (95%CI).
 Results: There were 731,373 admissions with a primary diagnosis of lung cancer in both sexes. Age >45 had higher IHM [17.2%] than those ≤ 44 years old [16.1%]. Odds ratio is 1.079 (1.042-1.118). Patient’s aged >45 also had higher IHM rate than those ≤ 44 years old in malignant neoplasms of upper lobe OR: 1.23 (1.14-1.32); bronchus with lung necrosis OR: 1.18 (1.10-1.28) and lung and bronchus, not otherwise specified OR: 1.11 (1.05-1.17)(P<0.001). The length of stay for primary lung cancer for all anatomical locations was 7.6 ± 0.10 days for patient’s aged ≤ 44 and 7.9 ± 0.02 days for >45 years old [t=2.316; df=1.07x10⁶; P=0.021].
 Conclusion: Patient’s aged >45 had higher in-hospital mortality in malignant neoplasms of upper lobe, bronchus with lung necrosis and lung and bronchus, not otherwise specified compared to ≤ 44 years old. Length of hospital stay was shorter for ≤ 44 years old in malignant neoplasms of the lung for all anatomical locations.