In this retrospective study, we described demographic information, reasons for admission, APACHE II severity scores, complications, mortality rate, causes of death and prognostic factors in 61 Thai patients with systemic lupus erythematosus (SLE) who were admitted to the medical intensive care unit (ICU) over a six-year period. The overall mortality rate during ICU hospitalization was 57% and the most common cause of death was infection, especially in the lower respiratory tract. The mean (SD) APACHE II score was 24.8 (10.8). SLE patients who had an APACHE II score of 20 or more were up to 65% of the patient population and had a significantly lower probability of survival based on Kaplan-Meier results (p = 0.004). The need for vasopressor therapy was significantly higher in patients who did not survive (OR = 6.98, 95% CI = 1.91-25.49). The patients who developed ventilator-associated pneumonia had a numerically higher mortality, which was not statistically significant (OR = 4.17, 95% CI = 0.91-19.03). The use of azathioprine as a steroid-sparing agent for SLE was associated with lower mortality rates (OR = 0.08, 95% CI = 0.01-0.58). Our findings emphasize that Thai SLE patients admitted to the medical ICU has a high mortality rate and early aggressive treatments are warranted.
Introduction The Health Assessment Questionnaire Disability Index (HAQ-DI) is a commonly used instrument to assess functional status of patients with rheumatoid arthritis (RA). Translations and adaptations of the HAQ-DI have been carried out for use with RA patients in several countries. The objective of this study was to evaluate the psychometric properties of the Thai version of the HAQ-DI (Thai HAQ) in Thai patients with RA.
Fasting blood samples taken from 93 pairs of outpatient systemic lupus erythematosus (SLE) women and matched controls were assessed for total cholesterol (TC), triglyceride (TG), high-density lipoprotein (HDL)- and low-density lipoprotein (LDL)-cholesterol. The demographic data, clinical manifestations, Mexican-SLE Disease Activity Index (MEX-SLEDAI), Systemic Lupus International Collaborating Clinics/American College of Rheumatology (SLICC/ACR) damage index and medication prescribed in the SLE patients were reviewed. A significant elevation of TG levels was observed in the SLE patients compared to controls (mean+/-SD 113.3+/-59.5 versus 77.7+/-45.7 mg/dL, P < 0.001). The HDL-c level was also significantly lower in SLE patients than controls (mean+/-SD 49.7+/-12.7 versus 65.0+/-14.8 mg/dL, P < 0.001). The percentage of samples with low HDL-c (<35 mg/dL) was higher in the SLE group (9.7%) than controls (0%; P = 0.002). The LDL-c and TC levels were comparable in both groups. The use of antimalarial drugs was negatively associated with TC (OR 0.22, 95%CI 0.08-0.61) and LDL-c levels (OR 0.27, 95%CI 0.09-0.80). The increased prevalence of dyslipoproteinemia in SLE patients in this report has confirmed the results of previous studies and emphasized the importance of controlling this modifiable cardiovascular risk factor by the combination of lifestyle modification and medical treatments.
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