OBJECTIVES: The objectives of this study were to describe the characteristics of patients who were hospitalized for lung cancer in West Virginia during the year 2007 and to identify predictors of in-hospital mortality. METHODS: Study data are drawn from 2007 hospital discharge records in the state of West Virginia, using the Agency for Health Research and Quality Healthcare Cost and Utilization Project State Inpatient Database (HCUP-SID). All patients who had a primary diagnosis of lung cancer were included in the study. Univariate and multivariate logistic regression analyses were used to identify patient characteristics that were associated with in-hospital mortality. RESULTS: In total, 1326 discharge records with lung cancer as primary diagnosis were identified. The average age of patients was 66 years, the mean length of stay in the hospital was 8 days, and the in-hospital mortality rate was 13%. Patients who had comorbid conditions and complications and patients who were grouped under the self-pay/no charge/ others category had greater odds of in-hospital mortality compared with patients who were covered by private insurance (P<0.05).   CONCLUSIONS: Patients with comorbid conditions and complications and patients without adequate insurance coverage had greater odds of in-hospital mortality. One reason for this may be inadequate access to care because of the absence of insurance or underinsurance. Further studies controlling for disease stage will be required to determine whether insurance status and patient-related factors can influence outcomes from lung cancer in individual patients independent of their disease stage.