Hospitalisation days in patients with lung cancer in a general population.

Background: Little is known concerning the hospitalisation of all lung cancer patients in a geographically defined population.

Method: All incident lung cancer patients in the Haugalandet area in South-west Norway from 1990 through 1996 were followed from diagnosis till either death or end of follow-up 1 December 2003. Initial symptoms, anatomical stage, functional performance status, histology, initial treatment, terminal care, number of admissions as well as days of hospitalisation were recorded.

Results: Of a total of 271 patients (57 women) only 16 were still alive at end of follow-up. Median survival time was 170 days. Mean age at the first admission was 67.4 years (range 21-89 years). Median number (inter quartile range) of admissions was 3 (2, 5) and total hospitalisation days 35 (18, 58). Altogether 26% of the days in institutional care were spent in nursing homes. The 31 patients surgically treated had the highest number of hospitalisation days: 75 (56, 96). Young age, low anatomical stage and good performance status at time of diagnosis were associated with increased use of hospitalisation days. Cox regression analysis showed that treatment interventions and dyspnoea were significant predictors when adjusting for age, tumour stage and performance status.

Conclusion: In a population-based cohort of incident lung cancer patients, days in health care institutions involved a large part (19%) of all survival time for those who died. However, the absolute number was greater for those with small tumours and high functional performance status which initiated other interventions than palliative treatment.