Outcome of patients with systematic lupus erythematosus in the intensive care unit

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.