In-ICU-acquired infections in flare-up systemic rheumatic disease patients receiving immunosuppressant

Chambrun, Marc Pineton de

doi:10.1007/s10067-022-06197-w

Cited by 2 publications

(1 citation statement)

References 28 publications

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“…The decreased risk of mortality observed among our AD patients who had a relatively longer ICU stay might be due to the supporting critical care and sufficient anti-sepsis therapy in an appropriate length of ICU stay [ 40 ]. As for immunosuppressants or biologics, a current study showed that the occurrence of sepsis among AD was not relevant to the use of immunosuppressants in the ICU [ 41 ]. but another small-scale study found biologics or corticosteroids could improve the 30-day survival of SLE patients with sepsis [ 39 ].…”

Section: Discussionmentioning

confidence: 99%

Prognostic impacts of repeated sepsis in intensive care unit on autoimmune disease patients: a retrospective cohort study

Yang,

Chen,

Zhang

et al. 2024

BMC Infect Dis

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Background Autoimmune diseases (ADs) may be complicated by sepsis when intensive care unit (ICU) admission. But repeated sepsis among AD patients has not been studied yet. The aim of this study is to investigate the impact of repeated in-ICU sepsis on the 1-year overall-cause mortality, septic shock and in-ICU death of AD patients. Methods Data of AD patients with sepsis retrieved from Medical Information Mart for Intensive Care IV (MIMIC-IV) database were divided into the single group and the repeated group according to the frequency of in-ICU sepsis. Propensity score matching was used to balance inter-group bias. Cox proportional hazard regression and sensitivity analysis were utilized to assess the variables on mortality. Results The incidence of repeated in-ICU sepsis in baseline was 19.8%. The repeated in-ICU sepsis was a risk factor for 1-year overall-cause mortality among AD patients (adjusted hazard ratio [HR] = 1.50, 95% CI: 1.16–1.93, P = 0.002), with robust adjusted HRs by the adjustment for confounders in the sensitivity analysis (all P < 0.01). Maximum Sequential Organ Failure Assessment (Max SOFA), Charlson comorbidity index (CCI) and Simplified Acute Physiology Score-II (SAPS-II) were risk factors for 1-year overall-cause mortality among AD with repeated sepsis (Max SOFA: HR = 1.09, P = 0.002; CCI: HR = 1.08, P = 0.039; SAPS-II: HR = 1.03, P < 0.001). Conclusions Compared to single hit, repeated in-ICU sepsis was independently related to a higher risk of 1-year overall-cause mortality among AD patients. Assessment tools (Higher SOFA, CCI and SAPS-II scores) were closely linked to poor prognosis of AD with repeated sepsis and helped to reflect ill physical conditions for the patients.

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Section: Discussionmentioning

confidence: 99%

Prognostic impacts of repeated sepsis in intensive care unit on autoimmune disease patients: a retrospective cohort study

Yang,

Chen,

Zhang

et al. 2024

BMC Infect Dis

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Short- and Long-Term Mortality of Hospitalized Patients With Autoimmune Rheumatic Diseases and Serious Infections: A National Cohort Study

Sagy,

Schwarzfuchs,

Zeller

et al. 2024

J Rheumatol

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ObjectiveInfectious conditions are a significant cause of mortality in autoimmune rheumatic diseases (ARD). Among patients hospitalized with an infection, we compared in-hospital and long-term (3-year) mortality between those with and without ARD.MethodsThis retrospective analysis included members of the largest health maintenance organization in Israel, aged > 18 years at the first episode of infection, who required hospitalization during 2003-2019. We compared in-hospital mortality and the results of a 3-year landmark analysis of those who survived the index hospitalization, between patients with ARD, according to disease subgroups, and patients without ARD. Additionally, we compared mortality outcomes among patients with ARD, according to subgroup diagnosis, matched in a 1:3 ratio, by age, sex, and ethnicity, to patients without ARD.ResultsIncluded were 365,257 patients who were admitted for the first time with the diagnosis of a serious infection. Of these, we identified 9,755 with rheumatoid arthritis (RA); 1,351 with systemic lupus erythematosus; 2,120 with spondyloarthritis (SPA); 584 with scleroderma; and 3,214 with vasculitis. In a matched multivariate analysis, the risk for in-hospital mortality was lower among patients with RA (odds ratio [OR] 0.89, 95% confidence interval [CI] 0.81-0.97) and SPA (OR 0.77, 95% CI 0.63-0.94). In a similar analysis, the risk of 3-year mortality was lower among patients with RA (hazard ratio [HR] 0.82, 95% CI 0.78-0.86) and vasculitis (HR 0.86, 95% CI 0.80-0.93).ConclusionAmong patients hospitalized for an infection, the risk of in-hospital and 3-year mortality was not increased among those with ARD compared to those without ARD.

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In-ICU-acquired infections in flare-up systemic rheumatic disease patients receiving immunosuppressant

Cited by 2 publications

References 28 publications

Prognostic impacts of repeated sepsis in intensive care unit on autoimmune disease patients: a retrospective cohort study

Prognostic impacts of repeated sepsis in intensive care unit on autoimmune disease patients: a retrospective cohort study

Short- and Long-Term Mortality of Hospitalized Patients With Autoimmune Rheumatic Diseases and Serious Infections: A National Cohort Study

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