# Inflammation-Related Parameters in Lung Cancer Patients Followed in the Intensive Care Unit

## TL;DR

This study examines how inflammation markers can predict mortality in lung cancer patients in the ICU, finding that PNI is a strong independent predictor.

## Contribution

The study identifies the Prognostic Nutritional Index (PNI) as an independent predictor of mortality in ICU lung cancer patients.

## Key findings

- PNI was the only inflammation-related parameter independently associated with mortality in multivariable analysis.
- APACHE II and MPM II-Admission scores showed high specificity in predicting mortality.
- mGPS, MPM II-Admission, and APACHE II scores had the highest sensitivity for mortality prediction.

## Abstract

Objectives: Lung cancer remains as the most common cause of cancer-related death. The possible relationships between inflammatory markers and lung cancer prognosis have yet to be clarified. In this study, we aimed to assess and compare various inflammatory markers and prognostic tests for their role in predicting mortality in patients with lung cancer who were admitted to the intensive care unit. Methods: A total of 229 patients diagnosed with small cell or non-small cell lung cancer who attended follow-up after treatment were included. The predictive performance of neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), systemic immune-inflammation index (SII), modified Glasgow prognostic score (mGPS), Prognostic nutritional index (PNI), APACHE II score, and MPM II-Admission (Mortality Probability Models II-0) were assessed in terms of mortality status. We also performed multivariable logistic regression to determine whether any of these parameters were independently associated with mortality. Results: We included 229 patients into our study; the mean age was 66.17 ± 11.89 years. Among these, 135 (58.95%) patients died and 94 (41.05%) patients were discharged. When we evaluated the performance of the prognostic scores in predicting mortality, we found mGPS, MPM II-Admission, and APACHE II scores had the highest sensitivity, and MPM II-Admission, PNI, and APACHE II scores had the highest specificity. Multivariable regression revealed that PNI was the only inflammation-related parameter that was independently associated with mortality. Conclusions: PNI, APACHE-II, and MPM II-Admission may be used as easily accessible tests for mortality estimation in lung cancer patients admitted to the ICU.