Lung Cancer Mortality and In-Hospital Outcomes in Chile: A Population-Based Cross-Sectional Study

Background/objective: Lung cancer (LC) remains the leading cause of cancer-related death worldwide. However, population-level evidence on long-term mortality trends and hospital outcomes in Latin America remains limited. This study aimed to analyze long-term mortality trends from LC in Chile and characterize hospitalization patterns and factors associated with in-hospital mortality. Methods: We conducted a population-based cross-sectional study using two independent administrative databases. Population-level lung cancer mortality trends were analyzed using national mortality records from DEIS (1997–2024), whereas hospitalization patterns and in-hospital mortality were analyzed using hospitalization episodes from the GRD-FONASA database (2019–2024). LC deaths were identified using ICD-10 codes C34. Hospitalizations were analyzed by demographics, primary diagnosis, and discharge status. Logistic regression models were used to evaluate factors associated with in-hospital mortality. Results: Age-adjusted mortality declined substantially among men (−35.5%) but increased slightly among women (+9%). Among hospitalization episodes recorded in the GRD-FONASA database, in-hospital mortality was 17.4%. In-hospital mortality was higher among men than women (18.7% vs. 15.8%), and male sex remained associated with increased odds of in-hospital death after adjustment for age (aOR 1.22; 95% CI 1.13–1.31). Lung cancer or metastasis was the principal diagnosis in 10,986/14,778 hospitalizations (74.3%) included in the selected diagnostic analysis. However, pneumonia and acute respiratory complications were disproportionately more frequent among hospitalizations ending in death. In multivariable analysis, pneumonia (aOR 2.05; 95% CI 1.77–2.38) and acute respiratory complications (aOR 2.13; 95% CI 1.83–2.48) were independently associated with in-hospital death. Conclusions: LC mortality trends in Chile diverged by sex, with declining age-adjusted mortality among men but increasing mortality among women. Respiratory infections and acute respiratory complications were strongly associated with in-hospital mortality, highlighting their importance as key targets for prevention and clinical management.