Arthur Mageau1, Karim Sacré2, Anne Perozziello3, Stéphane Ruckly3, Claire Dupuis4, Lila Bouadma4, Thomas Papo2, Jean-François Timsit4. 1. APHP Medical and infectious diseases ICU Bichat hospital, F75018 Paris, France; Département de Médecine Interne, Université Paris-Diderot, Assistance Publique Hôpitaux de Paris, Hôpital Bichat-Claude Bernard, Paris, France; IAME UMR 1137, Université Paris-Diderot Equipe 5 DeScID, France. Electronic address: arthur_mageau@hotmail.fr. 2. Département de Médecine Interne, Université Paris-Diderot, Assistance Publique Hôpitaux de Paris, Hôpital Bichat-Claude Bernard, Paris, France. 3. APHP Medical and infectious diseases ICU Bichat hospital, F75018 Paris, France; Département de Médecine Interne, Université Paris-Diderot, Assistance Publique Hôpitaux de Paris, Hôpital Bichat-Claude Bernard, Paris, France; IAME UMR 1137, Université Paris-Diderot Equipe 5 DeScID, France. 4. APHP Medical and infectious diseases ICU Bichat hospital, F75018 Paris, France; IAME UMR 1137, Université Paris-Diderot Equipe 5 DeScID, France.
Abstract
OBJECTIVES: We aimed to assess the characteristics, outcomes and costs of septic shock complicating Systemic Lupus Erythematosus (SLE). METHODS: Characteristics of SLE patients experiencing a septic shock in France from 2010 to 2015 were analyzed through the French medico-administrative database. Factors associated with the 1-year post-admission mortality were analyzed, the crude 1-year survival of SLE patients experiencing septic shock was compared to those admitted for another reason, and we compared the 1-year outcome associated with SLE septic shock survival to a matched SLE ICU control population. RESULTS: Among 28,522 SLE patients, 1068 experienced septic shock. The 1-year mortality rate was 43.4%. Independently of the severity, an associated Sjögren syndrome was the only specific SLE phenotype associated with mortality (HR 1.392[1.021-1.899]). Within one year, post-septic shock survivors (n = 738) were re-admitted 6.42[17.3] times with total cost of € 14,431[20,444]. Unmatched analysis showed that the outcome of patients admitted in ICU for septic shock was poorer than that of patients admitted in ICU or hospital for another disease. However, 1-year healthcare use of septic shock survivors was not different from the other ICU survivors when matched on severity. CONCLUSIONS: Septic shock is a frequent and severe complication among SLE patients even if it is not associated with more healthcare use than another episode of same severity.
OBJECTIVES: We aimed to assess the characteristics, outcomes and costs of septic shock complicating Systemic Lupus Erythematosus (SLE). METHODS: Characteristics of SLEpatients experiencing a septic shock in France from 2010 to 2015 were analyzed through the French medico-administrative database. Factors associated with the 1-year post-admission mortality were analyzed, the crude 1-year survival of SLEpatients experiencing septic shock was compared to those admitted for another reason, and we compared the 1-year outcome associated with SLE septic shock survival to a matched SLE ICU control population. RESULTS: Among 28,522 SLEpatients, 1068 experienced septic shock. The 1-year mortality rate was 43.4%. Independently of the severity, an associated Sjögren syndrome was the only specific SLE phenotype associated with mortality (HR 1.392[1.021-1.899]). Within one year, post-septic shock survivors (n = 738) were re-admitted 6.42[17.3] times with total cost of € 14,431[20,444]. Unmatched analysis showed that the outcome of patients admitted in ICU for septic shock was poorer than that of patients admitted in ICU or hospital for another disease. However, 1-year healthcare use of septic shock survivors was not different from the other ICU survivors when matched on severity. CONCLUSIONS:Septic shock is a frequent and severe complication among SLEpatients even if it is not associated with more healthcare use than another episode of same severity.