Critically ill systemic rheumatic disease (SRD) patients have benefited from better provision of rheumatic and critical care in recent years. Recent comprehensive data regarding in-hospital mortality and most importantly long-term outcome are scarce.
The aim of this study is to assess short and long-term outcome of patients with SRD admitted to the ICU.
and Methods: All records of patients with SRD admitted to intensive care unit (ICU) between 2006 and 2016 were reviewed. In-hospital and one-year mortality rates were assessed and predictive factors of mortality were identified.
A total of 525 SRD patients were included. Causes of admission were most frequently shock (40.8%) and acute respiratory failure (31.8%). Main diagnoses were infection (39%) and SRD flare-up (35%). In-hospital and one-year mortality rates were 30.5% and 37.7% respectively. Predictive factor associated with in-hospital and one-year mortalities were respectively: age, prior corticosteroid therapy, simplified acute physiology score II (SAPS II) ≥ 50, need for invasive mechanical ventilation or need for renal replacement therapy. Knaus scale C or D and prior conventional disease modifying anti-rheumatic drugs” (DMARDs) therapy was independently associated with mortality one-year after ICU admission.
Critically ill SRD patients had a fair outcome after ICU stay. Increased age, prior corticosteroid therapy and severity of critical illness were significantly associated with short and long-term mortality. One-year mortality was also associated with prior health status and conventional DMARDs therapy.
Copyright © 2020. Published by Elsevier Inc.
About The Expert
Romaric Larcher
Marc Pineton de Chambrun
Fanny Garnier
Emma Rubenstein
Julie Carr
Jonathan Charbit
Kevin Chalard
Marc Mourad
Matthieu Amalric
Laura Platon
Vincent Brunot
Zahir Amoura
Samir Jaber
Boris Jung
Charles-Edouard Luyt
Kada Klouche
References
PubMed