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.

References

PubMed