The prognostic significance of the Birmingham Vasculitis Activity Score (BVAS) with systemic vasculitis patients transferred to the intensive care unit (ICU)

Abstract

Systemic vasculitides represent a heterogeneous group of diseases that share clinical features including respiratory distress, renal dysfunction, and neurologic disorders. These diseases may often cause life-threatening complications requiring admission to an intensive care unit (ICU). The aim of the study was to evaluate the validity and responsiveness of Birmingham Vasculitis Activity Score (BVAS) score to predict survival in patients with systemic vasculitides admitted to ICU.A retrospective study was carried out from 2004 to 2014 in 18 patients with systemic vasculitis admitted to 2 different Rheumatology divisions and transferred to ICU due to clinical worsening, with a length of stay beyond 24 hours. We found that ICU mortality was significantly associated with higher BVAS scores performed in the ward (P = 0.01) and at the admission in ICU (P = 0.01), regardless of the value of Acute Physiology And Chronic Health Evaluation (APACHE II) scores (P = 0.50). We used receiver-operator characteristic (ROC) curve analysis to evaluate the possible cutoff value for the BVAS in the ward and in ICU and we found that a BVAS > 8 in the ward and that a BVAS > 10 in ICU might be a useful tool to predict in-ICU mortality.BVAS appears to be an excellent tool for assessing ICU mortality risk of systemic vasculitides patients admitted to specialty departments. Our experience has shown that performing the assessment at admission to the ward is more important than determining the evaluation before the clinical aggravation causing the transfer to ICU.

Value of prognostic scores in antineutrophil cytoplasmic antibody (ANCA) associated vasculitis patients in intensive care unit: a multicenter retrospective cohort study from Turkey

“…Burkhardt et al reported similar results in patients with Wegener's granulomatosis [19]. Some studies have shown a relationship between vasculitic activity and long-term and short-term (such as in ICU mortality) prognosis [20,21]. BVAS score has been used most frequently in these studies.…”

Inhibitory Anti-Peroxidasin Antibodies in Pulmonary-Renal Syndromes

“…24 Patients with anti-peroxidasin antibodies had significantly worse vasculitis activity ( Figure 4B; median 12 versus 2; P=0.02), and had a median score above values associated with substantially increased intensive care unit mortality. 25…”

Outcome of Patients With Necrotizing Vasculitis Admitted to the Intensive Care Unit (ICU) for Sepsis: Results of a Single-Centre Retrospective Analysis

“…28 A literature search on mortality of vasculitis patients under intensive care only brought up studies on ICU treatment in general. [4][5][6][7][8]10,[21][22][23][24] Investigations on ICU treatment for sepsis in particular are missing. We have found differing results while comparing our mortality to that in the literature.…”

“…[17][18][19] Contrary to patients with Rheumatoid Arthritis, 20 investigations on vasculitis and intensive care treatment for sepsis are scarce or address ICU treatment in general without focusing on sepsis in particular. [4][5][6][7][8]10,[21][22][23][24] We therefore planned to investigate retrospectively the outcome of sepsis in necrotizing vasculitis patients requiring intensive care treatment in a university hospital in Germany.…”