APHP Medical and infectious diseases ICU Bichat hospital, F75018 Paris, France; Département de Médecine Interne, Université Paris-Diderot, Assistance Publique Hôpitaux de Paris, Hôpital Bichat-Claude Bernard, Paris, France; IAME UMR 1137, Université Paris-Diderot Equipe 5 DeScID, France.
Département de Médecine Interne, Université Paris-Diderot, Assistance Publique Hôpitaux de Paris, Hôpital Bichat-Claude Bernard, Paris, France.
J Infect. 2019 Jun;78(6):432-438. doi: 10.1016/j.jinf.2019.04.005. Epub 2019 Apr 8.
We aimed to assess the characteristics, outcomes and costs of septic shock complicating Systemic Lupus Erythematosus (SLE).
Characteristics of SLE patients experiencing a septic shock in France from 2010 to 2015 were analyzed through the French medico-administrative database. Factors associated with the 1-year post-admission mortality were analyzed, the crude 1-year survival of SLE patients experiencing septic shock was compared to those admitted for another reason, and we compared the 1-year outcome associated with SLE septic shock survival to a matched SLE ICU control population.
Among 28,522 SLE patients, 1068 experienced septic shock. The 1-year mortality rate was 43.4%. Independently of the severity, an associated Sjögren syndrome was the only specific SLE phenotype associated with mortality (HR 1.392[1.021-1.899]). Within one year, post-septic shock survivors (n = 738) were re-admitted 6.42[17.3] times with total cost of € 14,431[20,444]. Unmatched analysis showed that the outcome of patients admitted in ICU for septic shock was poorer than that of patients admitted in ICU or hospital for another disease. However, 1-year healthcare use of septic shock survivors was not different from the other ICU survivors when matched on severity.
Septic shock is a frequent and severe complication among SLE patients even if it is not associated with more healthcare use than another episode of same severity.
评估红斑狼疮（SLE）并发感染性休克的特征、结局和费用。
通过法国医疗管理数据库分析 2010 年至 2015 年法国 SLE 患者发生感染性休克的特征。分析与入院后 1 年死亡率相关的因素，比较感染性休克后 SLE 患者的 1 年生存率与因其他原因入院的患者，比较与 SLE 感染性休克生存相关的 1 年结局与匹配的 SLE ICU 对照组。
在 28522 例 SLE 患者中，有 1068 例发生感染性休克。1 年死亡率为 43.4%。无论严重程度如何，合并干燥综合征是唯一与死亡率相关的特定 SLE 表型（HR 1.392[1.021-1.899]）。在 1 年内，感染性休克幸存者（n=738）再入院 6.42[17.3]次，总费用为 14431 欧元[20444 美元]。非匹配分析显示，因感染性休克入住 ICU 的患者的结局比因其他疾病入住 ICU 或医院的患者差。然而，当按严重程度匹配时，感染性休克幸存者的 1 年医疗保健使用与其他 ICU 幸存者无差异。
感染性休克是 SLE 患者常见且严重的并发症，尽管与同一严重程度的其他疾病相比，其医疗保健使用并没有增加。
