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 ery thematosus admitted to the intensive care unit (ICU). Design: Retrospe ctive 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 Res ults: There were 28 female and two male patients. Fifteen patients wer e white, 11 patients were black, and four patients were Asian. The med ian age was 29 yrs. The reasons for admission to the ICU were multifac torial. However, most patients were admitted for infective, renal, car diac, 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 pretreatm ent factor that predicted a poor outcome was the presence of renal inv olvement due to systemic lupus erythematosus. Conclusions: Our study s uggests that patients with systemic lupus erythematosus admitted to an ICU often have florid disease manifestations with multifactorial reas ons precipitating the admission. The prognosis for such patients is po or, particularly in the presence of renal involvement.