Patients with systemic rheumatic diseases are rarely admitted in intensive care units and very few studies focusing on the prognosis of those patients have been published.
Retrospective study over seven years in two intensive care units.
Among 33 patients with systemic disease diagnosed 90 +/- 133 months before admission in the intensive care unit, who were aged 50 +/- 21 years and represented a total of 39 stays in the intensive care unit, the main cause of admission was acute respiratory failure (33%). Mean simplified acute physiology score (SAPS II) was 47 +/- 22. Two-thirds of the patients were under mechanical ventilation. Infection was diagnosed in 33% of the cases and exacerbation of the systemic rheumatic disease in 26%. Nosocomial infection was found in 19 patients (49%). Ten patients died during their stay in the intensive care unit, six from infection, three from an exacerbation of the systemic rheumatic disease, one from an unidentified cause.
Even if severity scores of patients suffering from systemic diseases are higher at admission in intensive care units than those of other patients, there is no relevant reason to refuse critical care to these patients.