Cargando…
Factors Associated with Mortality in Patients with Autoimmune Diseases Admitted to the Intensive Care Unit in Bogota, Colombia
Patients with autoimmune diseases (ADs) are a challenge for the intensivist; it is hard to differentiate among infection, disease activity, and combinations of both, leading to high mortality. This study is a retrospective analysis of 124 critically ill patients admitted to the intensive care unit (...
Autores principales: | , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2017
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5362627/ https://www.ncbi.nlm.nih.gov/pubmed/28386264 http://dx.doi.org/10.3389/fimmu.2017.00337 |
_version_ | 1782516987997454336 |
---|---|
author | Carrizosa, Jorge Armando Aponte, Jorge Cartagena, Diego Cervera, Ricard Ospina, Maria Teresa Sanchez, Alexander |
author_facet | Carrizosa, Jorge Armando Aponte, Jorge Cartagena, Diego Cervera, Ricard Ospina, Maria Teresa Sanchez, Alexander |
author_sort | Carrizosa, Jorge Armando |
collection | PubMed |
description | Patients with autoimmune diseases (ADs) are a challenge for the intensivist; it is hard to differentiate among infection, disease activity, and combinations of both, leading to high mortality. This study is a retrospective analysis of 124 critically ill patients admitted to the intensive care unit (ICU) in a university hospital between 2008 and 2016. Bivariate case–control analysis was performed, using patients who died as cases; later, analysis using a logistic regression model with variables that were associated with mortality was conducted. Four variables were consistently associated with mortality in the logistic regression model and had adequate prediction value (Hosmer and Lemeshow statistic = 0.760; Nagelkerke R-squared = 0.494). The risk of death was found to be statistically associated with the following: shock at admission to ICU [odds ratio (OR): 7.56; 95% confidence interval (CI): 1.78–31.97, p = 0.006], hemoglobin level <8 g/dL (OR: 16.12; 95% CI: 3.35–77.52, p = 0.001), use of cytostatic agents prior to admission to the ICU (OR: 8.71; 95% CI: 1.23–61.5, p = 0.03), and low levels ofcomplement C3 (OR: 5.23; 95% CI: 1.28–21.35, p = 0.02). These variables can guide clinicians in the early identification of patients with AD with increased risk of death during hospitalization, leading to initial therapies seeking to improve survival. These results should be evaluated prospectively in future studies to establish their predictive power. |
format | Online Article Text |
id | pubmed-5362627 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-53626272017-04-06 Factors Associated with Mortality in Patients with Autoimmune Diseases Admitted to the Intensive Care Unit in Bogota, Colombia Carrizosa, Jorge Armando Aponte, Jorge Cartagena, Diego Cervera, Ricard Ospina, Maria Teresa Sanchez, Alexander Front Immunol Immunology Patients with autoimmune diseases (ADs) are a challenge for the intensivist; it is hard to differentiate among infection, disease activity, and combinations of both, leading to high mortality. This study is a retrospective analysis of 124 critically ill patients admitted to the intensive care unit (ICU) in a university hospital between 2008 and 2016. Bivariate case–control analysis was performed, using patients who died as cases; later, analysis using a logistic regression model with variables that were associated with mortality was conducted. Four variables were consistently associated with mortality in the logistic regression model and had adequate prediction value (Hosmer and Lemeshow statistic = 0.760; Nagelkerke R-squared = 0.494). The risk of death was found to be statistically associated with the following: shock at admission to ICU [odds ratio (OR): 7.56; 95% confidence interval (CI): 1.78–31.97, p = 0.006], hemoglobin level <8 g/dL (OR: 16.12; 95% CI: 3.35–77.52, p = 0.001), use of cytostatic agents prior to admission to the ICU (OR: 8.71; 95% CI: 1.23–61.5, p = 0.03), and low levels ofcomplement C3 (OR: 5.23; 95% CI: 1.28–21.35, p = 0.02). These variables can guide clinicians in the early identification of patients with AD with increased risk of death during hospitalization, leading to initial therapies seeking to improve survival. These results should be evaluated prospectively in future studies to establish their predictive power. Frontiers Media S.A. 2017-03-23 /pmc/articles/PMC5362627/ /pubmed/28386264 http://dx.doi.org/10.3389/fimmu.2017.00337 Text en Copyright © 2017 Carrizosa, Aponte, Cartagena, Cervera, Ospina and Sanchez. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Immunology Carrizosa, Jorge Armando Aponte, Jorge Cartagena, Diego Cervera, Ricard Ospina, Maria Teresa Sanchez, Alexander Factors Associated with Mortality in Patients with Autoimmune Diseases Admitted to the Intensive Care Unit in Bogota, Colombia |
title | Factors Associated with Mortality in Patients with Autoimmune Diseases Admitted to the Intensive Care Unit in Bogota, Colombia |
title_full | Factors Associated with Mortality in Patients with Autoimmune Diseases Admitted to the Intensive Care Unit in Bogota, Colombia |
title_fullStr | Factors Associated with Mortality in Patients with Autoimmune Diseases Admitted to the Intensive Care Unit in Bogota, Colombia |
title_full_unstemmed | Factors Associated with Mortality in Patients with Autoimmune Diseases Admitted to the Intensive Care Unit in Bogota, Colombia |
title_short | Factors Associated with Mortality in Patients with Autoimmune Diseases Admitted to the Intensive Care Unit in Bogota, Colombia |
title_sort | factors associated with mortality in patients with autoimmune diseases admitted to the intensive care unit in bogota, colombia |
topic | Immunology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5362627/ https://www.ncbi.nlm.nih.gov/pubmed/28386264 http://dx.doi.org/10.3389/fimmu.2017.00337 |
work_keys_str_mv | AT carrizosajorgearmando factorsassociatedwithmortalityinpatientswithautoimmunediseasesadmittedtotheintensivecareunitinbogotacolombia AT apontejorge factorsassociatedwithmortalityinpatientswithautoimmunediseasesadmittedtotheintensivecareunitinbogotacolombia AT cartagenadiego factorsassociatedwithmortalityinpatientswithautoimmunediseasesadmittedtotheintensivecareunitinbogotacolombia AT cerveraricard factorsassociatedwithmortalityinpatientswithautoimmunediseasesadmittedtotheintensivecareunitinbogotacolombia AT ospinamariateresa factorsassociatedwithmortalityinpatientswithautoimmunediseasesadmittedtotheintensivecareunitinbogotacolombia AT sanchezalexander factorsassociatedwithmortalityinpatientswithautoimmunediseasesadmittedtotheintensivecareunitinbogotacolombia |