Factors associated with mortality and infections in patients with systemic lupus erythematosus with diffuse alveolar hemorrhage
| Autor: | José de Jesús Eduardo Gómez-Bañuelos, Luz María Suárez-Larios, Miguel Ángel Saavedra, Ronald R. Butendieck, Diego Luis Carrillo Pérez, Andy Abril, Sandra Enciso-Peláez, Carlos Abud-Mendoza, Javier Merayo-Chalico, Diana Gómez-Martín, Enrique Faugier-Fuentes, Marco Ulises Martínez-Martínez, David Vega-Morales, Jorge Alcocer-Varela, Rocío Maldonado-Velázquez, Anne K Sturbaum, Julio Casasola-Vargas, Fedra Irazoque-Palazuelos |
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| Rok vydání: | 2014 |
| Předmět: |
Adult
Lung Diseases Male medicine.medical_specialty Adolescent medicine.medical_treatment Immunology Hemorrhage Comorbidity Infections Sex Factors Rheumatology Juvenile SLE Risk Factors Internal medicine Chart review medicine Immunology and Allergy Humans Lupus Erythematosus Systemic In patient Registries Renal Insufficiency Child Retrospective Studies Mechanical ventilation business.industry Age Factors Diffuse alveolar hemorrhage Respiration Artificial Thrombocytopenia Pulmonary Alveoli Survival Rate C-Reactive Protein Health evaluation Female business |
| Zdroj: | The Journal of rheumatology. 41(8) |
| ISSN: | 0315-162X |
| Popis: | Objective.To evaluate factors associated with mortality and infections in patients with systemic lupus erythematosus (SLE) and diffuse alveolar hemorrhage (DAH).Methods.A retrospective chart review was carried out for medical admissions of patients with a diagnosis of SLE and DAH in 9 hospitals. Clinical and laboratory data were recorded for each patient at DAH diagnosis.Results.We included 57 episodes of DAH of 50 patients (7 recurrences), 49 women (86%), 14 juvenile SLE (24.6%); 24 had died (42.1%). In the chart review we detected infection in 22 episodes (38.6%): 8 invasive fungal infections, 16 bacterial infections, and 2 patients had both types. In the bivariate analysis, factors associated with mortality were high Acute Physiology and Chronic Health Evaluation II scores, requirement of mechanical ventilation (OR 15.0, 95% CI 1.9 to 662.2), infections (fungal or bacterial; OR 3.2, CI 0.9 to 11.1), renal failure (OR 4.9, CI 1.4 to 18.0), and thrombocytopenia (OR 4.3, CI 1.2 to 15.6). We found similar mortality between children and adults. Infections were associated with treatment for SLE, requirement of mechanical ventilation, hypocomplementemia, and high levels of C-reactive protein.Conclusion.Infection is a frequent finding in patients with DAH and SLE; we found similar mortality between adult SLE and juvenile SLE. Factors that we describe associated with infections may influence the therapeutic selection for these patients. |
| Databáze: | OpenAIRE |
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