One-Year Outcome of Critically Ill Patients With Systemic Rheumatic Disease: A Multicenter Cohort Study.

Abstract

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.

• Authors: 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
• Journal: Chest (Chest) Vol. 158 Issue 3 Pg. 1017-1026 (09 2020) ISSN: 1931-3543 [Electronic] United States
• PMID: 32289313 (Publication Type: Journal Article, Multicenter Study, Observational Study)
• Copyright: Copyright © 2020 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

Chemical References

• Adrenal Cortex Hormones

Topics

• 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, therapy)
• Risk Factors