Dataset Information

Impact of systemic lupus erythematosus on the 5-year survival of critically ill septic patients.

ABSTRACT:

Background

Infectious disease is an increasing threat to patients with systemic lupus erythematosus (SLE); however, the long-term outcome in critically ill septic patients with SLE remains unclear, and we aimed to address the impact of SLE on 5-year survival in critically ill septic patients.

Methods

We used the 2003-2017 nationwide data with 825,556 patients with sepsis in Taiwan. We identified lupus cases with sepsis that required admission to the intensive care unit and mechanical ventilation and selected controls matched (1:4) for age, sex, and index-year. Conditional logistic regression analysis was used to determine risk factors for mortality risk and shown as odds ratios (HRs) with 95% confidence intervals (CIs).

Results

A total of 513 SLE-sepsis patients and 2052 matched non-SLE septic individuals were enrolled. The mortality rate was higher in the SLE group (38.5 per 100,000 person-year) than that in the non-SLE group (13.7 per 100,000 person-year), with an IRR of 2.8 (95% CI, 2.5-3.2). We found that SLE was independently associated with a high mortality rate after adjusting relevant variables (HR 1.47, 95% CI 1.27-1.77). In addition to SLE, a higher age (HR 1.02, 95% CI 1.02-1.02), more comorbidities, and receiving prednisolone equivalent dose higher than 5 mg/day (HR 1.55, 95% CI 1.27-1.90), methotrexate (HR 2.19, 95% CI 1.61-2.99), and immunosuppressants (HR 1.45, 95% CI 1.22-1.74) were also independent risks for mortality.

Conclusions

We identified that SLE affects the long-term mortality in critically ill septic patients, and more studies are warranted for the underlying mechanism.

SUBMITTER: Chen HH

PROVIDER: S-EPMC8528659 | biostudies-literature | 2021 Oct

REPOSITORIES: biostudies-literature

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Publications

Impact of systemic lupus erythematosus on the 5-year survival of critically ill septic patients.

Chen Hsin-Hua HH Chen Hsian-Min HM Chen Yi-Ming YM Chen Yi-Hsing YH Lin Ching-Heng CH Chao Wen-Cheng WC

Arthritis research & therapy 20211021 1

<h4>Background</h4>Infectious disease is an increasing threat to patients with systemic lupus erythematosus (SLE); however, the long-term outcome in critically ill septic patients with SLE remains unclear, and we aimed to address the impact of SLE on 5-year survival in critically ill septic patients.<h4>Methods</h4>We used the 2003-2017 nationwide data with 825,556 patients with sepsis in Taiwan. We identified lupus cases with sepsis that required admission to the intensive care unit and mechani ...[more]

PMID: 34674749

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Project description:BackgroundHospitalized patients with systemic lupus erythematosus (SLE) often require critical care, and SLE is the most common autoimmune disease in the intensive care unit (ICU). Mental disorders are highly prevalent among patients with SLE and are associated with increased morbidity and premature death in this population. However, the association of mental disorders with ICU utilization among patients with SLE and their prognostic impact among those admitted to ICU is unknown.MethodsWe performed a retrospective cohort study, using the Texas Inpatient Public Use Data File to identify SLE hospitalizations aged ≥ 18 years during 2009 - 2014. Mental disorders were defined by the taxonomy of the Healthcare Cost and Utilization Project's Clinical Classification Software Category 5. The patterns of ICU admission among SLE hospitalizations with and without mental disorders were examined. Multivariable logistic regression modeling was used to examine the association of mental disorders and short-term mortality (defined as hospital death or discharge to hospice) among ICU admissions.ResultsAmong 94,338 SLE hospitalizations 35,793 (37.9%) had mental disorders. There was no difference in the rates of ICU admission among SLE hospitalizations with and without mental disorders (37% vs. 37.2%, respectively; P = 0.5999), and similar rates of mental disorders were found among SLE hospitalizations with and without ICU admission (37.8% vs. 38%, respectively; P = 0.5408). The volume of SLE ICU admissions with and without mental disorders rose between 2009 and 2014 by 60.3% vs. 7.9%, respectively. When compared to those without mental disorders, SLE ICU admissions with mental disorders were older (age ≥ 65 years, 23.6% vs. 21.4%, respectively) and had higher burden of comorbid conditions. Unadjusted short-term mortality among SLE ICU admissions with and without mental disorders was 4.8% and 5.8%, respectively and mental disorders were associated with lower short-term mortality on adjusted analyses (adjusted odds ratio (aOR): 0.826; 95% confidence interval (CI): 0.734 - 0.930).ConclusionsThere was no difference in the frequency of mental disorders among hospitalized patients with SLE with and without ICU admission. However, the growth in the volume of ICU admissions with SLE over time involved predominantly patients with mental disorders. Among ICU admissions, mental disorders were associated with lower short-term mortality.

Dataset Information

Impact of systemic lupus erythematosus on the 5-year survival of critically ill septic patients.

Background

Methods

Results

Conclusions

Publications

Impact of systemic lupus erythematosus on the 5-year survival of critically ill septic patients.

Similar Datasets

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