Do obstructive lung diseases affect outcomes in lung cancer patients?

Abstract

e20034 Background: Obstructive lung diseases, particularly chronic obstructive pulmonary disease (COPD), have a pronounced impact on the outcomes of patients diagnosed with lung cancer. The simultaneous occurrence of COPD and lung cancer is prevalent, primarily due to the shared major risk factor of smoking. Research indicates that individuals with COPD possess a two- to fivefold elevated risk of developing lung cancer in comparison to smokers who do not have COPD. This increased risk persists even after controlling for smoking history, suggesting that COPD itself constitutes an independent risk factor for lung cancer development. Methods: A retrospective analysis was performed using the National Inpatient Sample database from 2016 to 2020, along with ICD-10 codes, to identify patients aged 18 and older with a primary diagnosis of lung cancer. The study assessed the impact of COPD on mortality, morbidity, and resource utilization in lung cancer patients. Categorical variables were analyzed with the chi-square test, while continuous variables were compared using the t-test. Multivariate analysis was conducted to calculate odds ratios, and all weighted analyses were carried out using STATA MP 17.0. Results: A total of 1,099,235 patients with a primary diagnosis of lung cancer were identified, of whom 26.88% had COPD. The average age of lung cancer patients with COPD was 67.94 years, compared to 64.76 years for those without. Among the lung cancer patients with COPD, 47% were female (p<0.001), and the racial distribution was 69% White, 19% Black, and 7% Hispanic (p<0.001). The majority of diagnoses were made in the Southern US (44%), followed by the Midwest (21%) (p<0.001). After adjusting for confounders, patients with COPD had significantly higher odds of mortality, increased resource utilization, and greater morbidity compared to those without these conditions (Table). Conclusions: Obstructive lung diseases, particularly COPD, significantly affect the outcomes for lung cancer patients. The coexistence of these conditions leads to a higher risk of developing lung cancer and is linked to poorer prognosis and survival rates. Understanding the interplay between COPD and lung cancer is crucial for developing effective treatment strategies and improving patient outcomes. Impact of COPD on lung cancer hospitalizations. Outcomes with COPD(%) Without COPD (%) Adjusted Odds Ratio* 95% Confidence Interval p-value Mortality 63.49 62.32 1.13 1.10-1.15 <0.001 ICU admission 4.44 4.04 1.24 1.18-1.30 <0.001 Pneumothorax 4.15 2.70 1.77 1.68-1.87 <0.001 Pulmonary hypertension 11.54 6.51 1.53 1.48-1.58 <0.001 Pleural effusion 1,57 1.4 1.17 1.08-1.27 <0.001 Pneumonia 12.13 10 1.40 1.35-1.45 <0.001 *Adjusted for confounders, patient and hospital level characters, baseline demographics and cardiac comorbidities.