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  • Original Articles

    Characteristics of patients with systemic lupus erythematosus admitted to the intensive care unit in a brazilian teaching hospital

    Rev Bras Ter Intensiva. 2008;20(3):249-253

    Abstract

    Original Articles

    Characteristics of patients with systemic lupus erythematosus admitted to the intensive care unit in a brazilian teaching hospital

    Rev Bras Ter Intensiva. 2008;20(3):249-253

    DOI 10.1590/S0103-507X2008000300007

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    OBJECTIVES: Due to the high incidence in our service, we did object on this study describe the features and outcome of patients with systemic lupus erythematosus (SLE) admitted to the intensive care unit of Walter Cantídio University Hospital METHODS: Patients were restrospectively characterized according to demography parameters, time of diagnosis of SLE, organ dysfunction and laboratorial parameters at admission, supportive therapies during their stay, length of stay in the hospital before admission, length of stay in the unit, readmission to the unit and outcome. We also evaluated Systemic Lupus Erythematosus Disease Activity (SLEDAI) score, Acute Physiology and Chronic Health Evaluation II (APACHE II) score, expected mortality and standardized mortality ratio. RESULTS: From November 2003 to October 2006, 1,052 patients were admitted to the intensive care unit. Fifty patients had SLE and were included in this retrospective study. Of the 50 patients with SLE admitted to the ICU, 88.2% were female. The mean age was 30.3 ± 12.8 years. The median time of diagnosis of SLE was 67 months. The most common organ dysfunctions were renal (70.6%), cardiovascular (61.8%), respiratory (55.9%) and neurological (55.9%). The main reasons for admission to the ICU were respiratory (38.2%), cardiologic (29.4%) and neurological (29.4%) dysfunctions. Among the intensive care therapies, 44.1% of the patients needed blood products, 41.2% vasopressor agents and 35.3% mechanical ventilation, 23.5% dialysis. The mean SLEDAI score was 15.0 ± 12.2. The mean APACHE II score was 19.3 ± 6.8, with a predicted mortality rate of 37.6%. The actual mortality rate in ICU was 29.4%, with 8.8% before 48 hours. The standardized mortality ratio was 0.78. Patients with APACHE II > 18, with more than 3 acute organ involvements, leukopenia (< 4000 cells/mm3) and gastrointestinal or metabolic involvement had higher mortality in the intensive care unit. CONCLUSION: Although the severity of patients at admission to the ICU, demonstrated by APACHE II and the acute dysfunctions, the outcomes of analysed patients sugest susceptibility to the therapy.

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    Characteristics of patients with systemic lupus erythematosus admitted to the intensive care unit in a brazilian teaching hospital
  • Original Articles - Clinical Research

    Gender and mortality in sepsis: do sex hormones impact the outcome?

    Rev Bras Ter Intensiva. 2011;23(3):297-303

    Abstract

    Original Articles - Clinical Research

    Gender and mortality in sepsis: do sex hormones impact the outcome?

    Rev Bras Ter Intensiva. 2011;23(3):297-303

    DOI 10.1590/S0103-507X2011000300007

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    OBJECTIVE: Comparative assessment of the mortality rates of two septic patients' ages and/or gender subgroups, admitted to the intensive care unit of a university hospital. METHODS: From December 2005 to April 2008, from a total of 628 patients, 133 were admitted to the intensive care unit with sepsis and included into two age subgroups: (G1) 14 - 40 years old and (G2) more than 50 years old. Patients aged between 41 and 50 years old (n = 8) were excluded. Demographic data, prognostic indicators (APACHE II score, organ dysfunction and circulatory shock) and outcome (mortality) were analyzed. RESULTS: Of the G1 patients (n = 44), 27 were female (61.4%), and in G2 (n = 81), 40 were female (49.4%). For both groups, mean APACHE II scores, multi-organ dysfunction and progression to circulatory shock rates were not significantly different between female and male patients. For G1, overall mortality rate was lower in female than in male patients (P = 0.04), while for G2, the opposite trend was observed. CONCLUSIONS: In this sample, reproductive age female patients younger than 40 years old showed lower mortality rates compared with age-matched male patients; for patients older than 50 years old, male patients had lower mortality rates than female patients.

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    Gender and mortality in sepsis: do sex hormones impact the outcome?

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