Outcome of patients with systematic lupus erythematosus in the intensive care unit
© BioMed Central Ltd 2005
Published: 7 March 2005
The objective of the study was to identify the causes, outcome and prognosis of severe illness in patients with systematic lupus erythematosus (SLE) requiring ICU care in a university hospital over a 5-year period. The design was a cohort study. Forty-eight SLE patients requiring ICU management over a 5-year period (January 1997–December 2001) were studied prospectively. Of 48 patients, 14 (29.2%) died, predominantly with multiorgan dysfunction syndrome (MODS). Patients whose APACHE II score was ≥ 20 had higher mortality than those with APACHE score < 20 (60% vs 7.1%; P < 0.01). All 18 patients whose health status was rated as 'good' survived, while 46.7% of 30 patients whose health was rated as 'poor' died (P < 0.01). Patients who had thrombocytopenia associated with sepsis and/or disseminated intravascular coagulopathy had the highest mortality (75%, 5-year survival). In conclusion, SLE patients admitted to the ICU had a lower mortality rate than some of the previous reports. Patients with SLE with high APACHE score > 20, poor health status, thrombocythopenia and MODS had poor prognosis in the ICU.