Short and longterm outcomes for patients with systemic rheumatic diseases admitted to intensive care units: a prognostic study of 181 patients

J Rheumatol. 1997 Jul;24(7):1317-23.


Objective: To determine short and longterm outcomes and prognostic factors for patients with systemic rheumatic diseases admitted to intensive care units in 4 teaching hospitals.

Methods: All adult intensive care unit admissions over a 12 year period for systemic rheumatic diseases were retrospectively assessed. One hundred and eighty-one patients with a mean age of 57 +/- 17 years were studied.

Results: The death rate in intensive care units was 33% (59/181) and in-hospital mortality was 43% (77/181). One hundred and four patients were discharged alive from hospital; 40 died during followup (mean 105 +/- 7 mo). The estimated 5 year survival rate for the discharged patients was 69%. The 4 factors significantly associated with in-hospital mortality by multivariate analysis were simplified acute physiologic score (p = 10(-4)), poor prior health status (p = 10(-4)), corticosteroid administration (p = 0.005), and the reason for admission; mortality was higher in the group admitted to intensive care for infectious complication (55 versus 34% for others; p = 0.006). In contrast, in-hospital mortality was not influenced by age or by systemic rheumatic diseases. Using Cox's model, only age over 60 years was a prognostic factor significantly associated with an increase in longterm mortality (p = 10(-4)).

Conclusion: The short term outcome for patients with systemic rheumatic diseases in intensive care units was poor. The longterm prognosis after hospital discharge appeared fair, although the standardized mortality ratio was 5-fold that of a nonselected population. Short and longterm prognoses were similar for different systemic rheumatic disease groups.

MeSH terms

  • Adult
  • Aged
  • Connective Tissue Diseases / complications
  • Fasciitis, Necrotizing / complications
  • Female
  • Hospitals, Teaching* / statistics & numerical data
  • Humans
  • Intensive Care Units* / statistics & numerical data
  • Male
  • Middle Aged
  • Outcome Assessment, Health Care*
  • Prognosis
  • Retrospective Studies
  • Rheumatic Diseases / complications
  • Rheumatic Diseases / mortality*
  • Rheumatic Diseases / therapy
  • Scleroderma, Systemic / complications
  • Survival Analysis
  • Time Factors