First hospitalization in lung cancer patients - is timing important?

Lung cancer patients have more visits to the emergency room compared to other types of cancer, resulting in an increased number of admissions and high in hospital mortality. We aimed to evaluate the prognostic impact of a first acute hospital admission in this population. We designed a retrospective observational study including lung cancer patients diagnosed in a tertiary referral center in 2016, with follow-up until December 2020. 90 patients were included, the majority were male (n=69; 76.7%), with a mean age of 67 years. Most were stage IV at diagnosis (n=51; 56.7%). The most common histological type was Adenocarcinoma (n=42; 46.7%). Those admitted at diagnosis had significantly higher mortality (p<0.001), even in non-metastatic stages. Moreover, the median length of stay was significantly higher in patients admitted at diagnosis compared to those admitted during follow-up (p=0.006). Patients who were never acutely admitted had better survival rates (p<0.001). Stage IV patients had higher admission rates on first observation (p=0.001) and significantly longer length-of-stay (p=0.046) compared to earlier stages. They had their first hospitalization earlier after diagnosis (p<0.001) and a higher number of admissions in the first 2 years of follow-up (p=0.031). In conclusion, time of first hospitalization could be a prognostic factor in lung cancer patients. Advanced staging was associated with poorer prognosis and earlier admissions.