Lupus eritematoso sistémico en la unidad de cuidados intensivos de urgencias

Objectives

To compare the characteristics of patients who died versus those who survived with systemic lupus erythematosus (SLE) in the emergency intensive care unit (UCIE).

Material and methods

Retrospective collection of clinical and laboratory findings of clinical histories of patients with SLE in the UCIE of the Hospital Clínico Quirúrgico de Holguín in the period from January 2016 to January 2021. A descriptive statistical study and univariate analysis were carried out for continuous and discrete variables. The APACHE II score was calculated.

Results

There were 23 patients with SLE during the period worked. The frequency of SLE in the ICU of the Hospital Clínico Quirúrgico de Holguín is 1.5%, it is the most frequent rheumatic pathology in ICU. Mortality in the ICU was 39.13%. The most frequent reason for admission was respiratory failure (52.4%), mostly due to an infectious cause. The variables that were significantly associated with mortality in the UCIE were: high erythrocyte sedimentation rate (ESR), severe anemia, severe hypoalbuminemia, the relationship arterial oxygen pressure between the fraction of inspired oxygen (PaFi) < 200 on admission. The APACHE II score in the deceased group was significantly higher (19.9) (P<.01). Acute renal failure requiring hemodialysis and the need for invasive mechanical ventilation in different modalities for variable times were significantly associated with higher mortality in ICU.

Conclusions

SLE in the ICU of the Hospital Clínico Quirúrgico de Holguín has a high mortality rate, higher than that reported in previous studies. Poor prognostic factors were high ESR, severe anemia, severe hypoalbuminemia, PaFi < 200, high APACHE II score, need for hemodialysis and invasive mechanical ventilation.