Ayşe ÇAPAR, Aslı Mezide DULKADİROĞLU, Şeyma BAŞLILAR, Güzide TOMAS
Anatolian Current Medical Journal - 2026;8(5):828-835
Aims: This study aimed to compare the costs, clinical features, and management strategies in the intensive care unit (ICU) between patients with terminal-stage lung cancer and those with non-malignant respiratory conditions. Additionally, factors associated with ICU costs and differences in clinical characteristics by in-hospital mortality status were evaluated. Methods: This retrospective observational study involved 250 patients monitored in the pulmonary ICU from January 2020 to December 2025. Of these, 190 had terminal-stage lung cancer, and 60 required ICU admission for non-malignant respiratory conditions. Retrospective analyses included demographic characteristics, Acute Physiology and Chronic Health Evaluation (APACHE II) scores, ICU interventions, complications, in-hospital mortality data, and ICU-related costs. Results: The total ICU cost was higher for patients with terminal-stage lung cancer compared to the non-malignant patient group [1736.20 United States Dollar (USD) vs. 1161.02 USD, respectively; p=0.010]. The terminal-stage lung cancer group exhibited significantly higher rates of mechanical ventilation (MV) (88.4% vs. 60.0%; p<0.001), vasopressor (VP) use (91.1% vs. 65.0%; p<0.001), broad-spectrum antibiotic use (86.3% vs. 66.7%; p<0.001), and in-hospital mortality (87.4% vs. 51.7%; p<0.001). Multivariable gamma regression analysis showed that prolonged ICU length of stay, the development of infectious complications, and use of renal replacement therapy (RRT) were independently associated with higher ICU costs (both p<0.05). Conclusion: Terminal-stage lung cancer patients admitted to the ICU experienced substantially higher mortality and greater healthcare resource utilization than patients admitted for non-malignant respiratory conditions. Although overall ICU expenditures were higher in this population, the lack of a significant difference in daily ICU costs suggests that the increase is largely attributable to prolonged ICU stays and complication-related care rather than to greater day-to-day treatment intensity. These findings highlight the importance of optimizing ICU resource utilization and strengthening palliative care services to support appropriate and sustainable end-of-life care.
