Clinical characteristics and outcomes of systemic lupus erythematosus patients admitted to Assiut University Hospital critical care unit.

Abstract

Systemic lupus erythematosus (SLE) is a chronic autoimmune disease that may cause severe complications. This study aimed to investigate the frequency of critical complications in SLE patients requiring intensive care unit (ICU) admission and to identify potential risk factors affecting their outcomes. The study included 50 SLE patients admitted to the Critical Care Unit. All patients underwent a comprehensive medical history, physical examination and laboratory investigations. Disease activity was assessed using the modified new version of the SLE disease activity index (SLEDAI-2K). Both the Acute Physiology and Chronic Health Examination-II (APACHE-II) score and the Sequential Organ Failure Assessment score (SOFA score) were calculated within 24-hour period post-admission. Patients were followed until hospital discharge or demise. The mean age of the studied patients was 33.62 years, with a range of 20 to 47 years. The most leading causes of admission were lupus nephritis (44%) and pneumonia (24%). Of these patients, 12 (24%) patients developed different forms of complications. Of the patients, 80% survived, while 20% experienced a fatal outcome. The predictors of mortality were older age (odds ratio 1.59), complications (odds ratio 2.09), and high APACHE-II scores (odds ratio 3.11). In conclusion, patients with SLE admitted to the critical care unit were liable for complications in the presence the following risk factors; old age, high disease activity and high APACHE-II.