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Thirty-day mortality in hospitalised patients with lung cancer: incidence and predictors
  1. Alessandro Leonetti1,
  2. Marianna Peroni2,
  3. Virginia Agnetti2,
  4. Fabiana Pratticò2,
  5. Martina Manini2,
  6. Alessandro Acunzo2,
  7. Francesca Marverti2,
  8. Simone Sulas2,
  9. Elena Rapacchi1,
  10. Giulia Mazzaschi1,2,
  11. Fabiana Perrone1,
  12. Paola Bordi1,
  13. Sebastiano Buti1,2 and
  14. Marcello Tiseo1,2
  1. 1Medical Oncology Unit, University Hospital of Parma, Parma, Italy
  2. 2Department of Medicine and Surgery, University of Parma, Parma, Italy
  1. Correspondence to Dr Marianna Peroni, Department of Medicine and Surgery, University of Parma, Parma, Italy; marianna.peroni{at}


Objectives Patients with lung cancer experience high rates of hospitalisation, mainly due to the high risk of complications that emerge during the natural history of the disease. We designed a retrospective, single-centre, observational study aimed at defining the clinical predictors of 30-day mortality in hospitalised patients with lung cancer.

Methods Clinical records from the first admission of patients with lung cancer to the oncology ward of the University Hospital of Parma from 1 January 2017 to 1 January 2022 were collected.

Results 251 consecutive patients were enrolled at the time of data cut-off. In the univariate analysis, baseline clinical predictors of 30-day mortality were Eastern Cooperative Oncology Group performance status (ECOG PS) (≥2 vs 0–1: 27.5% vs 14.8%, p=0.028), high Blaylock Risk Assessment Screening Score (BRASS) (high vs intermediate-low: 34.3% vs 11.9%, p<0.001), presence of pain (yes vs no: 24.4% vs 11.7%, p=0.009), number of metastatic sites (≥3 vs <3: 26.5% vs 13.4%, p=0.017) and presence of bone metastases (yes vs no: 29.0% vs 10.8%, p=0.001). In the multivariate analysis, high BRASS remained significantly associated with increased 30-day mortality (high vs intermediate-low; OR 2.87, 95% CI 1.21 to 6.78, p=0.016).

Conclusion Our results suggest that baseline poor ECOG PS, high BRASS, presence of pain, high tumour burden and presence of bone metastases could be used as clinical predictors of 30-day mortality in hospitalised patients with lung cancer. In particular, the BRASS scale should be used as a simple tool to predict 30-day mortality in hospitalised patients with lung cancer.

  • lung
  • hospital care

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  • Contributors Design of the research: AL, MT. Submission to ethical committee: AL, MP, ER. Guarantor: AL. Patients’ enrolment: MP, VA, FPr, MM, AA, FM, SS, GM, FPe, PB, SB. Data collection: MP, VA, FPr, MM, AA, FM, SS. Statistical analysis: AL, GM, SB. Writing—original draft preparation: AL, MP. Writing—review and editing: AL, MP, VA, FPr, MM, AA, FM, SS, ER, GM, FPe, PB, SB, MT. Supervision: SB, MT.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests AL has received speakers’ fees for AstraZeneca and MSD. AL has been on advisory boards for BeiGene, Novartis and Sanofi. MT received speakers’ and consultants’ fee from AstraZeneca, Pfizer, Eli Lilly, BMS, Novartis, Roche, MSD, Boehringer Ingelheim, Otsuka, Takeda, Pierre Fabre, Amgen, Merck and Sanofi. MT received institutional research grants from AstraZeneca and Boehringer Ingelheim.

  • Provenance and peer review Not commissioned; internally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.