Factores asociados a mortalidad en pacientes con enfermedades autoinmunes en cuidado intensivo, Hospital de la Samaritana 2007-2013

Abstract

Background: Autoimmune diseases have high mortality rates. The purpose of this study was research for risk factors related to mortality. Methods: We conducted a single center, retrospective case-control study, based on medical records review from patients hospitalized in the critical care unit with diagnosis of an autoimmune disease at the Hospital Universitario de la Samaritana.. We collect 68 patients and the primary end point was mortality. Results: Autoimmune diseases were more frequently among women (66%), systemic lupus erythematosus was the most common disease (36%), clinical and laboratory criteria were met in 77% cases, average age was 46 years old, the mean for days in mechanical ventilation was 10 days (SD 13 days), mean for APACHE II score was 19 points, the organic system more frequently affected was renal system (58,5%), global mortality rate was 40%. Mortality risk significantly increased among patients with shock (OR: 7.368; 95% CI, 1.886 to 28.794); procalcitonin level over 10 ng/ml (OR: 5.231 95% CI, 1.724 to 15.869); C3 complement under normal (OR: 4.014 95% CI, 1.223 to 13.173); serositis on chest X ray (OR: 3.771 95% CI, 1.238 to 11.492); and platelet count below 100.000 (OR: 3.33 95% CI, 1.037 to 10.714). Conclusions: There are factors that could be related to mortality in patients with autoinmune diseases who are critically ill. To identify as soon as possible those factors would be accompanied with a better prognosis.