Mortality in patients with systemic lupus erythematosus in Colombia: a case series

Aguirre-Valencia, David; Suárez-Avellaneda, Ana; Ocampo-Piraquive, Vanessa; Posso-Osorio, Iván; Naranjo-Escobar, Juan; Nieto-Aristizábal, Ivana; Tobón, Gabriel J.; Cañas, Carlos A.

doi:10.1007/s10067-019-04546-w

Cited by 11 publications

(10 citation statements)

References 22 publications

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“…91 In the study by Aguirre-Valencia et al., the first cause of mortality was SLE activity refractory to immunosuppressive treatment, mainly associated with CAPS. 93 In addition, it has been reported that the survival of patients with SLE and antiphospholipid antibody syndrome is significantly lower than in patients with SLE only. 53…”

Section: Discussionmentioning

confidence: 99%

Systemic lupus erythematosus in the intensive care unit: a systematic review

Suárez-Avellaneda

Quintana

Aragón

et al. 2020

Lupus

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Systemic lupus erythematosus (SLE) is an autoimmune disease with heterogeneous pathophysiologic mechanisms and diverse clinical manifestations. SLE is a frequent cause of intensive care unit (ICU) admissions. Multiple studies with controversial findings on the causes, evolution and outcomes of ICU-admitted patients with SLE have been published. The aim of this paper is to review the literature reporting the clinical characteristics and outcomes, such as mortality and associated factors, in such patients. Among the main causes of ICU admissions are SLE disease activity, respiratory failure, multi-organ failure and infections. The main factors associated with mortality are a high Acute Physiology and Chronic Health Evaluation (APACHE) score, the need for mechanical ventilation, and vasoactive and inotropic agent use. Reported mortality rates are 18.4%–78.5%. Therefore, it is important to evaluate SLE disease severity for optimizing clinical management and patient outcomes.

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Section: Discussionmentioning

confidence: 99%

Systemic lupus erythematosus in the intensive care unit: a systematic review

Suárez-Avellaneda

Quintana

Aragón

et al. 2020

Lupus

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“…A mortality of 7.63% was found. This data is important since most mortality studies of patients with AIDs have been done by sub-phenotype (i.e., specific disease analyzed) [ 11 , 20 ]. Other studies exclusively analyzed this outcome in patients admitted to the ICU [ 21 ], and others evaluated mortality in AIDs in general and not in hospitalized patients [ 22 ].…”

Section: Discussionmentioning

confidence: 99%

Prevalence of hospital readmissions and related factors in patients with autoimmune diseases

Morales-Tisnés

Quintero-Ortiz

Quintero-Muñoz

et al. 2021

Journal of Translational Autoimmunity

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Objective Autoimmune diseases generate an impact on the morbidity and mortality of patients and are a burden for the health system through hospital admissions and readmissions. The prevalence of readmission of patients with these diseases has not yet been described as a group, but rather as sub-phenotype. The objective of this study is to determine the prevalence of hospital readmissions in a Colombian population with autoimmunity and the factors related to readmission. Methods All patients with autoimmune diseases who were evaluated by the rheumatology service and hospitalized between August 2018 and December 2019 at the Fundación Hospital Infantil Universitario De San José de Bogotá were described. A bivariate analysis was done, and three multivariate logistic regression models were built with the dependent variable being readmission. Results Of the total 199 admissions, 131 patients were evaluated and 32% were readmitted. The most frequent sub-phenotype in both groups (readmission and no readmission) was SLE (51% and 59%). The most frequent cause of hospitalization and readmission was disease activity (68.7% and 64.3%). History of hypertension was associated with readmission (adjusted OR: 2.98–95% CI: 1.15–7.72). In a second model adjusted for confounding variables, no factor was associated. In a third model analyzing the history of kidney disease and previous use of immunosuppressants (adjusted for confounding variables), the previous use of immunosuppressants was related to readmission (OR: 2.78–95% CI 1.12–6.89). Conclusion Up to a third of patients with autoimmunity were readmitted and arterial hypertension was an associated factor. This suggested a greater systemic compromise and accumulated damage in patients who have these two conditions that may favor readmission. A history of immunosuppressant use may play a role in readmission, possibly by increasing the risk of developing infections.

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“…It is known that IVIG is capable of protecting against infections, 17 which are a common clinical problem and one of the principal causes of mortality in SLE patients. 18–21 Furthermore, IVIG presents an additional advantage when immunosuppressants cannot be considered due to suspicion of concomitant infection.…”

Section: Discussionmentioning

confidence: 99%

“…11,14 Causes of mortality were also similar to those in other studies. 21,28,29 We are aware that using IVIG could be limited due to its cost. Nonetheless, approaches involving biological therapy may result in equal or higher healthcare costs in the health system.…”

Section: Discussionmentioning

confidence: 99%

Treatment with intravenous immunoglobulins in systemic lupus erythematosus: a single-center experience with 63 patients

Nieto-Aristizábal

Martínez

Urbano

et al. 2019

Lupus

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Background Intravenous immunoglobulin (IVIG) is prepared using purified human plasma. IVIG therapy has immunomodulatory effects on autoimmune diseases, including severe systemic lupus erythematosus (SLE). However, reports of its effects on large cohorts are scarce. Methods This single-center retrospective study included SLE patients treated with at least one IVIG cycle for SLE complications. Demographic data, indications, cycle numbers, and clinical improvement with IVIG were evaluated. SLE Disease Activity Index 2000 (SLEDAI-2K) scores were calculated at admission and after IVIG treatment in order to measure clinical improvement. Results Sixty-three SLE patients treated with IVIG (median age: 29 years; interquartile range 21–36 years; 84.13% female) were included, who received 2 g/kg IVIG for two to five days. Main indications were immune thrombocytopenia, hypogammaglobulinemia, infection during a SLE flare, bicytopenia, and immune hemolytic anemia. Seven patients received more than one IVIG cycle without severe adverse effects. Significant differences were found in SLEDAI-2K scores when the indications were immune thrombocytopenia and hypogammaglobulinemia, with a trend for hemolytic anemia. Patients with concomitant infection, myopathy, and gastrointestinal involvement showed a considerable reduction in their last SLEDAI-2K scores. Fourteen patients died during hospitalization, mainly due to septic shock and active SLE. Conclusions IVIG showed adequate tolerance and effectiveness in selected severe SLE manifestations, mainly hematological involvement. It was useful for concomitant infection.

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Mortality in patients with systemic lupus erythematosus in Colombia: a case series

Cited by 11 publications

References 22 publications

Systemic lupus erythematosus in the intensive care unit: a systematic review

Systemic lupus erythematosus in the intensive care unit: a systematic review

Prevalence of hospital readmissions and related factors in patients with autoimmune diseases

Treatment with intravenous immunoglobulins in systemic lupus erythematosus: a single-center experience with 63 patients

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