Study of critically ill patients with systemic lupus erythematosus.

OBJECTIVES

To determine the presenting features, prognostic factors, course, and outcome of critically ill patients with systemic lupus erythematosus admitted to the intensive care unit (ICU).

DESIGN

Retrospective patient record review.

SETTING

Two academic teaching hospitals.

PATIENTS

All patients with systemic lupus erythematosus admitted to the ICUs between January 1982 and July 1993.

MEASUREMENTS AND MAIN RESULTS

There were 28 female and two male patients. Fifteen patients were white, 11 patients were black, and four patients were Asian. The median age was 29 yrs. The reasons for admission to the ICU were multifactorial. However, most patients were admitted for infective, renal, cardiac, or coagulation complications. Despite aggressive management, 16 (53%) patients died in the ICU or shortly after discharge. The median ICU survival rate (admission to death) was 22 days. The only pretreatment factor that predicted a poor outcome was the presence of renal involvement due to systemic lupus erythematosus.

CONCLUSIONS

Our study suggests that patients with systemic lupus erythematosus admitted to an ICU often have florid disease manifestations with multifactorial reasons precipitating the admission. The prognosis for such patients is poor, particularly in the presence of renal involvement.