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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 (...

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Autores principales: Carrizosa, Jorge Armando, Aponte, Jorge, Cartagena, Diego, Cervera, Ricard, Ospina, Maria Teresa, Sanchez, Alexander
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
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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.
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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
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