Clinical presentations and outcomes of systemic lupus erythematosus patients with infection admitted to the intensive care unit

Abstract

SLE patients with infection in the ICU had a higher mortality and a higher APACHE II score compared to SLE patients with noninfectious causes in the ICU. Their physiologic signs including temperature, HR, and SBP were more reflective of infection than their WBC count.

Good prognosis for hospitalized SLE patients with non-related disease

“…SLE patients with infection in the ICU had a higher APACHE score, were hemodynamically unstable and had a longer stay in the ICU when compared to SLE patients without infection. Patient mortality did not differ among those with infection with or without-SLE [20]. Mortality was 40% in the SLE infected group and 10% in the SLE non-infected group [20].…”

“…SLE patients are more prone to infections for many reasons: inherent defective immune regulation, inherited complement deficiencies, and immune-suppression from medications [17,20]. Although SLE patients in our study were hospitalized for infections, none were considered severe infections or sepsis.…”

“…Patient mortality did not differ among those with infection with or without-SLE [20]. Mortality was 40% in the SLE infected group and 10% in the SLE non-infected group [20]. In another study, there was a 47% mortality rate among 51 lupus patients in the ICU [21].…”

Epidemiology and outcomes of sepsis among hospitalizations with systemic lupus erythematosus admitted to the ICU: a population-based cohort study

“…Numerous studies have described infections among ICU-managed SLE patients [11,[17][18][19][20][21][22][23]. However, sepsis affects only about half of ICU patients with an infection in the general population [15] and inferences about sepsis in studies of ICU-managed SLE patients with infections are limited in part because investigators have often conflated infection and sepsis.…”

“…However, sepsis affects only about half of ICU patients with an infection in the general population [15] and inferences about sepsis in studies of ICU-managed SLE patients with infections are limited in part because investigators have often conflated infection and sepsis. Thus, sepsis was either not mentioned [19], not defined [17], used interchangeably with infection [22], or used as a category of site-specific infections [20]. The generalizability of prior studies is further affected by use of single-centered [11, 17-19, 22, 23], small cohort data [11, 17-19, 21, 22], with most of the data being over a decade old [11,[17][18][19][20]23].…”