ABSTRACT
Our objective was to compare the pattern of organ dysfunctions and outcomes of critically ill patients with systemic lupus erythematosus (SLE) with patients with other systemic rheumatic diseases (SRD). We studied 116 critically ill SRD patients, 59 SLE and 57 other-SRD patients. The SLE group was younger and included more women. Respiratory failure (61 percent) and shock (39 percent) were the most common causes of ICU admission for other-SRD and SLE groups, respectively. ICU length-of-stay was similar for the two groups. The 60-day survival adjusted for the groups’ baseline imbalances was not different (P = 0.792). Total SOFA scores were equal for the two groups at admission and during ICU stay, although respiratory function was worse in the other-SRD group at admission and renal and hematological functions were worse in the SLE group at admission. The incidence of severe respiratory dysfunction (respiratory SOFA >2) at admission was higher in the other-SRD group, whereas severe hematological dysfunction (hematological SOFA >2) during ICU stay was higher in the SLE group. SLE patients were younger and displayed a decreased incidence of respiratory failure compared to patients with other-SRDs. However, the incidences of renal and hematological failure and the presence of shock at admission were higher in the SLE group. The 60-day survival rates were similar.
Subject(s)
Adult , Female , Humans , Male , Middle Aged , Hematologic Diseases/epidemiology , Kidney Failure, Chronic/epidemiology , Lupus Erythematosus, Systemic/complications , Multiple Organ Failure/mortality , Respiration Disorders/epidemiology , Rheumatic Diseases/complications , Critical Illness , Epidemiologic Methods , Hematologic Diseases/etiology , Hospitalization/statistics & numerical data , Intensive Care Units , Kidney Failure, Chronic/etiology , Length of Stay/statistics & numerical data , Lupus Erythematosus, Systemic/mortality , Respiration Disorders/etiology , Rheumatic Diseases/classification , Rheumatic Diseases/mortalityABSTRACT
A importância crescente das doenças cardiovasculares como principal causa de morbidade e mortalidade é conhecida. A manifestação inicial da doença pode ser devastadora. O conhecimento de alguns fatores de risco, que, quando presentes, tornam a pessoa mais vulnerável à aquisição da doença, constitui os alicerces da profilaxia das doenças cardiovasculares. O exame clínico é parte essencial do check-up cardiológico e aliado à análise dos fatores de risco seleciona os exames complementares adequados. A partir do exame clínico e dos fatores de risco presentes utiliza-se o modelo de previsão de eventos de Framingham; para aqueles mais vulneráveis, adota-se uma atitude mais enérgica sobre os fatores de risco, devendo, quando necessário, ser indicada terapêutcia medicamentosa.