Outcome of patients with systemic lupus erythematosus in intensive care unit

The objective of the study was to identify the causes, outcome and prognosis of severe illness in patients with systemic lupus erythematosus (SLE) requiring intensive care unit (ICU) care in a University Hospital over a five-year period. The design was a cohort study. Forty-eight SLE patients requiring ICU management over a five-year period ( January 1997 - December 2001) were studied prospectively. Of 48 patients, 14 (29.2%) died, predominantly with multiorgan dysfunction syndrome ( MODS). Patients whose APACHE II score was equal to or greater than 20 had higher mortality than those with APACHE score below 20 ( 60 versus 7.1%; and P< 0.01). All the 18 patients whose health status rated as 'good' survived, while 46.7% of 30 patients whose health rated as 'poor' died (P< 0.01). Patients who had thrombocytopenia associated with sepsis and/or disseminated intravascular coagulopathy (DIC) had the highest mortality (75%, five-year survival). In conclusion, SLE patients admitted to the ICU had a lower mortality rate than some of the previous reports. Patients with SLE with high APACHE score, greater than or equal to20, poor health status, thrombocytopenia and multiorgan dysfunction syndrome had poor prognosis in the ICU.