Prognosis of patients with systemic lupus erythematosus in the intensive care unit

Abstract

Introduction: Identification of risk factors for mortality has enabled improving the treatment of critically ill patients with systemic lupus erythematosus. Objective: To describe clinical characteristics and prognoses of critically ill patients with systemic lupus erythematosus admitted to an intensive care unit. Method: Prospective, observational cohort study. A total of 207 patients with systemic lupus erythematosus admitted between January 2011 and January 2016 were included. Results: During the study period, 3,215 critically ill patients were admitted to the intensive care unit, out of which 207 (6.4%) were identified as having systemic lupus erythematosus after being evaluated by an intensivist. The multivariate analysis identified the presence of organ failure (cardiovascular, liver, neurological) and serum lactate levels > 2 mmoL/L at admission or within the first 24 hours of intensive care unit stay as the main factors associated with increased mortality. Conclusions: A relevant observation was that neurological failure and liver failure were associated with higher mortality risk at 28 days, without reports similar to these findings being identified.

Characteristics, outcomes and global trends of respiratory support in patients hospitalized with COVID-19 pneumonia: a scoping review

“…Length of stay was available for 30 studies 19,25,26,28,[38][39][40][43][44][45][46][47]49,50,[52][53][54][55]57,59,[61][62][63][64][65]67,68,[70][71][72] (57.7%). The mean duration of the hospital stay was of 13 days, ranging from a minimum of 6 days (IQR 3-14) 55 to a maximum of 63 days (IQR, 8-67) 68 (Supplementary Digital Material 1: Supplementary Figure 4).…”

“…The overall trend of IMV-related mortality is shown in Figure 4, and ranged from 4% in two cases 31,62 to ≥50% in 25/51 studies. 7,23,29,30,34,36,38,40,42,[46][47][48]50,[52][53][54][56][57][58][59]61,[65][66][67]70 Mortality during non invasive respiratory support Mortality in patients treated with CPAP was reported in 8/11 studies (73%), while mortality on NIV was available in 13/38 (34%) of studies. Cumulative mortality on CPAP was 24.8%, while on NIV was 29.1%.…”

“…Hospital-related complications were reported in 33 studies 19,23,24,26,28,32,36,39,40,[42][43][44][45][46][47][48]51,52,[55][56][57][58]60,61,[63][64][65][66][67][69][70][71][72] (63.4%) (Supplementary Digital Material 1: Supplementary Figure 5 and Supplementary Table 3). The most frequent complication was AKI/RRT (25 studies 23,24,26,28,32,36,39,42-45,47,48,52,55-58, 61,63,64,67,69,71,72 ), that ranged from 0.9% 26 to 55.7% 69 .…”

“…Mortality rates for patients exposed to IMV ranged from <10% 31,62 to ≥50% in 49% of cases 7,23,29,30,34,36,38,40,42,[46][47][48]50,[52][53][54][56][57][58][59]61,[65][66][67]70 , while overall mortality generally varied from 3-8% 28,33,36,60 to >70% 34,48 . We hypothesize that wide regional differences in IMV-related and overall mortality may derive from different local standard operating procedures and criteria for hospitalization, decision to start a trial of non invasive ventilation or CPAP, or criteria for intubation.…”