Objectives: Therapy outcomes for newly diagnosed, critically ill lung cancer patients have seldom been evaluated. This study evaluated therapy outcomes for treatment-naïve lung cancer patients in the intensive care unit (ICU).

Background: Patients with respiratory or cardiovascular diseases often experience higher rates of hospital readmission due to compromised heart-lung function and significant clinical symptoms. Effective measures such as discharge planning, case management, home telemonitoring follow-up, and patient education can significantly mitigate hospital readmissions. Objective: This study aimed to determine the efficacy of home telemonitoring follow-up in reducing hospital readmissions, emergency department (ED) visits, and total hospital days for high-risk postdischarge patients. Methods: This prospective cohort study was conducted between July and October 2021. High-risk patients were screened for eligibility and enrolled in the study. The intervention involved implementing home digital monitoring to track patient health metrics after discharge, with the aim of reducing hospital readmissions and ED visits. High-risk patients or their primary caregivers received education on using communication measurement tools and recording and uploading data. Before discharge, patients were familiarized with these tools, which they continued to use for 4 weeks after discharge. A project manager monitored the daily uploaded health data, while a weekly video appointment with the program coordinator monitored the heart and breathing sounds of the patients, tracked health status changes, and gathered relevant data. Care guidance and medical advice were provided based on symptoms and physiological signals. The primary outcomes of this study were the number of hospital readmissions and ED visits within 3 and 6 months after intervention. The secondary outcomes included the total number of hospital days and patient adherence to the home monitoring protocol. Results: Among 41 eligible patients, 93% (n=38) were male, and 46% (n=19) were aged 41-60 years, while 46% (n=19) were aged 60 years or older. The study revealed that home digital monitoring significantly reduced hospitalizations, ED visits, and total hospital stay days at 3 and 6 months after intervention. At 3 months after intervention, average hospitalizations decreased from 0.45 (SD 0.09) to 0.19 (SD 0.09; P=.03), and average ED visits decreased from 0.48 (SD 0.09) to 0.06 (SD 0.04; P<.001). Average hospital days decreased from 6.61 (SD 2.25) to 1.94 (SD 1.15; P=.08). At 6 months after intervention, average hospitalizations decreased from 0.55 (SD 0.11) to 0.23 (SD 0.09; P=.01), and average ED visits decreased from 0.55 (SD 0.11) to 0.23 (SD 0.09; P=.02). Average hospital days decreased from 7.48 (SD 2.32) to 6.03 (SD 3.12; P=.73). Conclusions: By integrating home telemonitoring with regular follow-up, our research demonstrates a viable approach to reducing hospital readmissions and ED visits, ultimately improving patient outcomes and reducing health care costs. The practical application of telemonitoring in a real-world setting showcases its potential as a scalable solution for chronic disease management.

Background: Lung cancer misdiagnosed as tuberculosis (TB) is not rare, but the factors associated with early diagnosis revision remain unclear. Methods: We screened the cases with TB notification from 2007 to 2018 and reviewed those with misdiagnosis with a revised diagnosis to lung cancer. We analyzed the factors associated with early diagnosis revision (≤1 months) and early obtained pathology (≤1 months) using multivariable Cox regression. Results: During the study period, 45 (0.7%) of 6683 patients were initially notified as having TB, but later diagnosed with lung cancer. The reasons for the original impression of TB were mostly due to image suspicion (51%) and positive sputum acid-fast stain (AFS) (27%). Using multivariable Cox proportional regression, early diagnosis revision was associated with obtaining the pathology early, lack of anti-TB treatment, and negative sputum AFS. Furthermore, the predictors for early obtained pathology included large lesion size (>3 cm), presence of a miliary radiological pattern, no anti-TB treatment, and a culture-negative result when testing for nontuberculous mycobacteria (NTM) using multivariable Cox regression. Conclusion: In patients who are suspected to have TB but no mycobacterial evidence is present, lung cancer should be kept in mind and pathology needs to be obtained early, especially for those with small lesions, radiological findings other than the miliary pattern, and a culture positive for NTM.