Outcome of systemic rheumatic disease patients admitted in intensive care unit

Objective

The aim of this study was the determination of short and longterm outcomes and prognostic factors for patients with systemic rheumatic diseases (SRD) admitted to intensive care units (ICU) in a retrospective case series study of SRD patients admitted in six French ICU in community and teaching hospital between January 1992 and July 1996.

Main results

A total of 60 SRD patients were included with diagnostic of infection (40%), acute exacerbation of SRD (16.7%), iatrogenic complication (16.7%), cardiovascular complication (15%), and miscellaneous (11.7%). The death rate in intensive care units was 26.7% (16/60). Multivariate analysis (Cox model) identified two factor predicting poor MICU outcome: age above 65 years (relative risk [RR], 3.3; 95% confidence interval [CI], 1.9–5.8) and Tran organ failure indices (RR, 2.2; 95% CI, 1.7–2.8). The mean overall survival time after admission to ICU was 18.8 months. The 1-year survival rate was 61.1%, and the 2-years 58.8%. Multivariate analysis (Cox model) identified two factors predicting poor long term outcome: age above 65 years (RR 4.0; 95% CI 2.7–6.0), and need of mechanical ventilation (RR, 6.5; 95% CI, 4.2–10.1) (Fig).

Conclusion

We conclude that this SRD patients should be admitted to the ICU on the same basis as other patients. In this population neither the diagnostic of the underlying disease, nor the use of immunosuppresive therapy did influence the short and long outcome. Long-term survival depended only on the age and the need of mechanical ventilation.

Figure

Survival of patients with SRD in intensive care unit, influence of mechanical ventilation.