Romaric Larcher1, Marc Pineton de Chambrun2, Fanny Garnier3, Emma Rubenstein4, Julie Carr5, Jonathan Charbit6, Kevin Chalard7, Marc Mourad8, Matthieu Amalric9, Laura Platon9, Vincent Brunot9, Zahir Amoura10, Samir Jaber11, Boris Jung12, Charles-Edouard Luyt13, Kada Klouche12. 1. Intensive Care Medicine Department, Lapeyronie Hospital, Montpellier, France; PhyMedExp, INSERM, CNRS, Montpellier, France. Electronic address: r-larcher@chu-montpellier.fr. 2. Department of Internal Medicine 2, E3M Institute, Paris, France; Medical Intensive Care Unit, Institute of Cardiology, La Pitie-Salpetriere Hospital, University of Paris 6, Paris, France. 3. Intensive Care Medicine Department, Lapeyronie Hospital, Montpellier, France; UPRES EA2415, Laboratory of biostatistics, Epidemiology, Clinical Research and Health Economics, University of Montpellier, Montpellier, France. 4. Internal Medicine Department, Saint Louis Hospital, University of Paris 7, Assistance Publique - Hopitaux de Paris, Paris, France. 5. Anesthesiology and Intensive Care Departments, Saint Eloi Hospital, Montpellier, France. 6. Lapeyronie Hospital, Montpellier, France. 7. Gui de Chauliac Hospital, Montpellier, France. 8. Arnaud de Villeneuve Hospital, University Hospital of Montpellier, Montpellier, France. 9. Intensive Care Medicine Department, Lapeyronie Hospital, Montpellier, France. 10. Department of Internal Medicine 2, E3M Institute, Paris, France. 11. Anesthesiology and Intensive Care Departments, Saint Eloi Hospital, Montpellier, France; PhyMedExp, INSERM, CNRS, Montpellier, France. 12. Intensive Care Medicine Department, Lapeyronie Hospital, Montpellier, France; PhyMedExp, INSERM, CNRS, Montpellier, France. 13. Medical Intensive Care Unit, Institute of Cardiology, La Pitie-Salpetriere Hospital, University of Paris 6, Paris, France.
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.
BACKGROUND:Critically illpatients 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 illpatients 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: Paul Chabert; William Danjou; Mehdi Mezidi; Julien Berthiller; Audrey Bestion; Abla-Akpene Fred; Claude Guerin; Laurent Argaud; Vincent Piriou; Eric Bonnefoy-Cudraz; Jean-Jacques Lehot; Jean-Luc Fellahi; Thomas Rimmele; Frederic Aubrun; Jean-Christophe Richard; Laure Gallay; Arnaud Hot Journal: Medicine (Baltimore) Date: 2021-09-03 Impact factor: 1.817