Study of critically ill patients with systemic lupus erythematosus.
OBJECTIVE
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).


METHODS
Retrospective patient record review.


METHODS
Two academic teaching hospitals.


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


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.
Ansell
S M
SM
Department of Medicine, University of the Witwatersand Medical School, Johannesburg, Republic of South Africa.
Bedhesi
S
S
Ruff
B
B
Mahomed
A G
AG
Richards
G
G
Mer
M
M
Feldman
C
C
D018806:APACHE; D000293:Adolescent; D000328:Adult; D016638:Critical Illness; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D008180:Lupus Erythematosus, Systemic / Q000150:complications / Q000401:mortality* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate