Prognostic factors of mortality in Iranian patients with systemic lupus erythematosus admitted to intensive care unit.
Alimohammad FatemiSomayeh ShamsaeeAhmad RaeisiZahra SayedbonakdarAbbas SmileyPublished in: Clinical rheumatology (2017)
The aim was to determine the course, outcome, and determinants of mortality in patients with systemic lupus erythematosus (SLE) in intensive care unit (ICU). SLE patients admitted to ICU from 2004 to 2015 were recruited retrospectively. Demographic data, disease characteristics, causes of admission, baseline SLE disease activity index-2K (SLEDAI-2K) and Acute Physiologic and Chronic Health Evaluation II (APACHE) score, the outcome, and the causes of death were recorded. Predictors of mortality were compared between alive and dead patients by Cox regression analysis. Ninety-four patients with SLE were enrolled. Mean age at the time of ICU admission was 29.6 years. Average scores of SLEDAI and APACHE II were 11.3 and 19.8, respectively. The most common causes of ICU admission were pneumonia, diffuse alveolar hemorrhage (DAH), and seizure. Forty-seven patients (50%) died in ICU. The principal causes of death were septic shock (25.5%), multi-organ failure (12.5%), DAH (10.6%), and pneumonia (10.6%). After multivariate analysis, high APACHE II, septic shock, and duration of mechanical ventilation were indicators of survival outcome. Mean (95% CI) survival days in ICU in patients with and without respiratory failure were 14.6 (10.4-18.9) and 28.7 (17.9-39.5) days, respectively (P = 0.001). This figure for those with and without septic shock was 13.5 (4.9-11.1) and 22.3 (9.3-24.7) days, respectively (P = 0.016). High APACHE II, septic shock, and duration of mechanical ventilation were the main predictors of death in patients with SLE in ICU. Multicenter studies are needed to draw a fine picture of SLE behavior in ICU.
Keyphrases
- mechanical ventilation
- septic shock
- respiratory failure
- intensive care unit
- disease activity
- systemic lupus erythematosus
- prognostic factors
- acute respiratory distress syndrome
- rheumatoid arthritis
- end stage renal disease
- ankylosing spondylitis
- emergency department
- rheumatoid arthritis patients
- chronic kidney disease
- newly diagnosed
- extracorporeal membrane oxygenation
- ejection fraction
- cardiovascular events
- mental health
- healthcare
- juvenile idiopathic arthritis
- type diabetes
- public health
- clinical trial
- cardiovascular disease
- data analysis
- low grade
- hepatitis b virus
- artificial intelligence
- deep learning
- risk assessment
- social media
- liver failure
- climate change
- patient reported