Systemic Sclerosis at an Intensive Care Unit

Abstract

The severity of the disease at ICU admission and comorbidity are independently associated with ICU-related mortality. Furthermore, the optimal management of SSc patients includes accurate detection of SSc-associated organ involvement. More studies involving this category of patients are needed to establish the best effective protocols.

Sepsis Mortality Is high in Patients With Connective Tissue Diseases Admitted to the Intensive Care Unit (ICU)

“…32 reported mortality showed a very wide range of 16 to 89%, mainly depending on the investigated diseases and the reason for ICU admission. 14,16,[25][26][27][28][29]33,[36][37][38][39][40] Therefore, most of the publications are difficult to compare to our well-defined group of septic CTD patients. A study by Heijnen et al (n ¼ 86), for example, consisted of only 18.6% patients with a CTD and 60% were admitted to the ICU for infection.…”

“…Bru ¨nnler et al 36 an ICU mortality of 43% in SSc patients, while the main causes of ICU admission were non-SSc-related (71.4%). 28 Shalev et al reviewed a small cohort of SSc patients (n ¼ 9) and found a high in-hospital mortality of 89%. 29 In this small group, sepsis was the main reason for ICU admission and death, with 62.5% of the deceased patients having a pulmonary involvement of the CTD.…”

“…According to the literature, the highest mortality was seen in SSc patients. 25,28,29 Multivariate logistic regression in our CTD cohort showed SSc diagnosis (and a high SOFA score) to be independent risk factors for non-survival. Most of the diseased SSc patients had a known pulmonary involvement.…”

“…5,[21][22][23] Despite the need for more data, investigations on CTDs and intensive care treatment for sepsis are rare or address ICU treatment in general without focusing on sepsis in particular. 14,16,[24][25][26][27][28][29] Consequently, this investigation was carried out to determine the in-hospital mortality of septic CTD patients requiring ICU treatment.…”