One-Year Outcome of Critically Ill Patients With Systemic Rheumatic Disease: A Multicenter Cohort Study.
APACHE
Adrenal Cortex Hormones
/ administration & dosage
Age Factors
Critical Illness
Female
France
/ epidemiology
Hospital Mortality
Humans
Intensive Care Units
Length of Stay
/ statistics & numerical data
Male
Middle Aged
Organ Dysfunction Scores
Renal Replacement Therapy
Respiration, Artificial
Retrospective Studies
Rheumatic Diseases
/ mortality
Risk Factors
ICU
corticosteroid
outcome
systemic rheumatic disease
Journal
Chest
ISSN: 1931-3543
Titre abrégé: Chest
Pays: United States
ID NLM: 0231335
Informations de publication
Date de publication:
09 2020
09 2020
Historique:
received:
05
12
2019
revised:
15
02
2020
accepted:
09
03
2020
pubmed:
15
4
2020
medline:
27
5
2021
entrez:
15
4
2020
Statut:
ppublish
Résumé
Critically ill patients with systemic rheumatic disease (SRD) have benefited from better provision of rheumatic and critical care in recent years. Recent comprehensive data regarding in-hospital mortality rates and, most importantly, long-term outcomes are scarce. The aim of this study was to assess short and long-term outcome of patients with SRD who were admitted to the ICU. All records of patients with SRD who were admitted to ICU between 2006 and 2016 were reviewed. In-hospital and one-year mortality rates were assessed, and predictive factors of death were identified. A total of 525 patients with SRD 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 factors that were associated with in-hospital and one-year mortalities were, respectively, age, prior corticosteroid therapy, simplified acute physiology score II ≥50, need for invasive mechanical ventilation, or need for renal replacement therapy. Knaus scale C or D and prior conventional disease modifying antirheumatic drug therapy was associated independently with death one-year after ICU admission. Critically ill patients with SRD had a fair outcome after an ICU stay. Increased age, prior corticosteroid therapy, and severity of critical illness were associated significantly with short- and long-term mortality rates. The one-year mortality rate was also associated with prior health status and conventional disease modifying antirheumatic drug therapy.
Sections du résumé
BACKGROUND
Critically ill patients with systemic rheumatic disease (SRD) have benefited from better provision of rheumatic and critical care in recent years. Recent comprehensive data regarding in-hospital mortality rates and, most importantly, long-term outcomes are scarce.
RESEARCH QUESTION
The aim of this study was to assess short and long-term outcome of patients with SRD who were admitted to the ICU.
STUDY DESIGN AND METHODS
All records of patients with SRD who were admitted to ICU between 2006 and 2016 were reviewed. In-hospital and one-year mortality rates were assessed, and predictive factors of death were identified.
RESULTS
A total of 525 patients with SRD 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 factors that were associated with in-hospital and one-year mortalities were, respectively, age, prior corticosteroid therapy, simplified acute physiology score II ≥50, need for invasive mechanical ventilation, or need for renal replacement therapy. Knaus scale C or D and prior conventional disease modifying antirheumatic drug therapy was associated independently with death one-year after ICU admission.
INTERPRETATION
Critically ill patients with SRD had a fair outcome after an ICU stay. Increased age, prior corticosteroid therapy, and severity of critical illness were associated significantly with short- and long-term mortality rates. The one-year mortality rate was also associated with prior health status and conventional disease modifying antirheumatic drug therapy.
Identifiants
pubmed: 32289313
pii: S0012-3692(20)30674-7
doi: 10.1016/j.chest.2020.03.050
pii:
doi:
Substances chimiques
Adrenal Cortex Hormones
0
Types de publication
Journal Article
Multicenter Study
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
1017-1026Informations de copyright
Copyright © 2020 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.