Prognostic factors for 90-day outcomes in lung cancer patients: a single centre study in 1000 real-world patients

<title>Abstract</title> <p>Background Frailty and comorbidity are common in lung cancer but are not routinely integrated into treatment decisions, which continue to rely largely on WHO performance status (PS). Methods We conducted a retrospective cohort study of 967 consecutive patients with NSCLC or SCLC referred for first oncology consultation at a UK tertiary centre (2021–2023). Treating clinicians were blinded to frailty (G8) and comorbidity (Charlson Comorbidity Index) scores. Primary outcomes were systemic anti‑cancer therapy (SACT) incompletion, emergency admission, and 90‑day mortality from first consultation. Multivariate logistic regression analysed independent predictors. Results 76.5% of patients aged ≥ 70 had G8 ≤ 14 and 65.7% of the full cohort had moderate–severe comorbidity, despite 61.0% being WHO‑PS 0–1. Within 90 days, 26.0% of patients initiating SACT failed to complete two cycles, 26.3% of treated patients were admitted, and 14.6% died. Albumin &lt; 3.5 g/dL was the strongest predictor of all outcomes. Additional predictors included stage, G8, PS, NLR, haemoglobin, socioeconomic deprivation, and gender. Age was not associated with any outcome. Conclusions Objective frailty, comorbidity, and simple laboratory markers identify patients at high risk of early harm, independent of age and beyond PS. Ninety‑day outcomes from first consultation offer a reproducible metric across modern treatment pathways.</p>