• Romaric Larcher, Pineton de Chambrun Marc M Department of Internal Medicine 2, E3M Institute, Paris, France; Medical Intensive Care Unit, Institute of Cardiology, La Pitie-Salpetriere Hos, Fanny Garnier, Emma Rubenstein, Julie Carr, Jonathan Charbit, Kevin Chalard, Marc Mourad, Matthieu Amalric, Laura Platon, Vincent Brunot, Zahir Amoura, Samir Jaber, Boris Jung, Charles-Edouard Luyt, and Kada Klouche.
• Intensive Care Medicine Department, Lapeyronie Hospital, Montpellier, France; PhyMedExp, INSERM, CNRS, Montpellier, France. Electronic address: r-larcher@chu-montpellier.fr.
• Chest. 2020 Sep 1; 158 (3): 1017-1026.

BackgroundCritically ill patients with systemic rheumatic disease (SRD) have benefited from better provision of rheumatic and critical care in recent years. Recent comprehensive data regarding in-hospital mortality rates and, most importantly, long-term outcomes are scarce.Research QuestionThe aim of this study was to assess short and long-term outcome of patients with SRD who were admitted to the ICU.Study Design And MethodsAll records of patients with SRD who were admitted to ICU between 2006 and 2016 were reviewed. In-hospital and one-year mortality rates were assessed, and predictive factors of death were identified.ResultsA total of 525 patients with SRD were included. Causes of admission were most frequently shock (40.8%) and acute respiratory failure (31.8%). Main diagnoses were infection (39%) and SRD flare-up (35%). In-hospital and one-year mortality rates were 30.5% and 37.7%, respectively. Predictive factors that were associated with in-hospital and one-year mortalities were, respectively, age, prior corticosteroid therapy, simplified acute physiology score II ≥50, need for invasive mechanical ventilation, or need for renal replacement therapy. Knaus scale C or D and prior conventional disease modifying antirheumatic drug therapy was associated independently with death one-year after ICU admission.InterpretationCritically ill patients with SRD had a fair outcome after an ICU stay. Increased age, prior corticosteroid therapy, and severity of critical illness were associated significantly with short- and long-term mortality rates. The one-year mortality rate was also associated with prior health status and conventional disease modifying antirheumatic drug therapy.Copyright © 2020 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

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