Sepsis Mortality Is high in Patients With Connective Tissue Diseases Admitted to the Intensive Care Unit (ICU)
| Autor: | Marco Krasselt, Christoph Baerwald, Sirak Petros, Olga Seifert |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Adult
Male medicine.medical_specialty dermatomyositis systemic sclerosis SLE Connective tissue Critical Care and Intensive Care Medicine intensive care unit law.invention Sepsis sepsis 03 medical and health sciences 0302 clinical medicine Mixed connective tissue disease systemic lupus erythematosus law Internal medicine connective tissue diseases systemic lupus erythematosus SLE systemic sclerosis dermatomyositis mixed connective tissue disease myositis sepsis mortality intensive care unit medicine Humans In patient 030212 general & internal medicine ddc:610 Myositis Original Research Aged Retrospective Studies 030203 arthritis & rheumatology business.industry Dermatomyositis Middle Aged medicine.disease Prognosis Intensive care unit mortality Intensive Care Units medicine.anatomical_structure ROC Curve mixed connective tissue disease Female CTD connective tissue diseases business myositis |
| Zdroj: | Journal of Intensive Care Medicine |
| ISSN: | 1525-1489 0885-0666 |
| Popis: | Objectives: Patients with connective tissue diseases (CTD) such as systemic lupus erythematosus (SLE) have an increased risk for infections. This study investigated the outcome and characteristics of CTD patients under intensive care unit (ICU) treatment for sepsis. Methods: A single-center retrospective analysis was conducted and reviewed all patients with a CTD diagnosis admitted to the ICU of a university hospital for sepsis between 2006 and 2019. Mortality was computed and multivariate logistic regression was used to detect independent risk factors for sepsis mortality. Furthermore, the positive predictive value of ICU scores such as Sequential Organ Failure Assessment (SOFA) score was evaluated. Results: This study included 44 patients with CTD (mean age 59.8 ± 16.1 years, 68.2% females), most of them with a diagnosed SLE (61.4%) followed by systemic sclerosis (15.9%). 56.8% (n = 25) were treated with immunosuppressives and 81.8% (n = 36) received glucocorticoids. Rituximab was used in 3 patients (6.8%). The hospital mortality of septic CTD patients was high with 40.9%. It was highest among systemic sclerosis (SSc) patients (85.7%). SOFA score and diagnosis of SSc were independently associated with mortality in multivariate logistic regression ( P = 0.004 and 0.03, respectively). The Simplified Acute Physiology Score II (SAPS II), SOFA and Acute Physiology and Chronic Health Evaluation II (APACHE II) scores were good predictors of sepsis mortality in the investigated cohort (SAPS II AUC 0.772, P = 0.002; SOFA AUC 0.756, P = 0.004; APACHE II AUC 0.741, P = 0.007). Conclusions: In-hospital sepsis mortality is high in CTD patients. SSc diagnoses and SOFA were independently associated with mortality. Additionally, common ICU scores were good predictors for mortality. |
| Databáze: | OpenAIRE |
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