We examined the demography, reasons for admission and cause of death in systemic lupus erythematosus (SLE) patients admitted to a medical intensive care unit (ICU) over a 7-year period. Fourteen patients were admitted during this period—all were female, 13 were of mixed ethnic ancestry and one a black South African. Of the 14 patients, 12 were admitted as a result of lupus activity, 2 had sepsis as the major cause of admission, although 5 other patients developed infection during their admission. Five patients had a generalised flare of their disease or progressive renal failure. Seven patients were admitted with a variety of lupus-related pathologies. In general the precise cause of death was difficult to determine. Of the 14 patients, 9 had impaired renal function on admission including 1 with sepsis and 1 of the survivors. Three patients (21%) survived, one with respiratory failure due to shrinking lung, a second with an acute flare of SLE and a third with pulmonary emboli. This study demonstrates that lupus in our community may produce life-threatening flares. Although cause of death was not always definitely identified, admission to the ICU was primarily due to active SLE and not sepsis or iatrogenic disease.
This is a preview of subscription content, log in to check access.
Buy single article
Instant unlimited access to the full article PDF.
Price includes VAT for USA
Subscribe to journal
Immediate online access to all issues from 2019. Subscription will auto renew annually.
This is the net price. Taxes to be calculated in checkout.
Klippel JH (1997) Systemic lupus erythematosus: demographics, prognosis and outcome. J Rheumatol 24 [Suppl 48]:67–71
Uramoto KM, Michet CJ, Thumbo J et al (1999) Trends in the incidence and mortality of systemic lupus erythematosus 1950–1992. Arthritis Rheum 42:46–50
Ginzler EM, Schorn K (1988) Outcome and prognosis in systemic lupus erythematosus. Rheum Dis Clin North Am 14:67–78
Gladman DD, Urowitz MB (1987) Morbidity in systemic lupus erythematosus. J Rheumatol 14 [Suppl 13]:223–226
Godeau B, Mortier E, Roy PM et al (1997) Short and long term outcomes for patients with systemic rheumatic diseases admitted to intensive care units: a prognostic study of 181 patients. J Rheumatol 24:1317–1323
Ansell SM, Bedhesi S, Ruff B et al (1996) Study of critically ill patients with systemic lupus erythematosus. Crit Care Med 24:981–984
Williams FMK, Chinn S, Hughes GRV, Leach RM (2002) Critical illness in systemic lupus erythematosus and the antiphospholipid syndrome. Ann Rheum Dis 61:414–421
Studenski S, Allen NB, Caldwell DS et al (1987) Survival in systemic lupus erythematosus. Arthritis Rheum 30:1326–1332
Paton NIJ, Cheong IKS, Kong NCT et al (1996) Risk factors for infection in Malaysian patients with systemic lupus erythematosus. Q J Med 89:531–538
Cohen MG, Li EK (1992) Mortality in systemic lupus erythematosus: active disease is the most important factor. Aust N Z J Med 22:5–8
Rosner S, Ginzler EM, Diamond HS et al (1982) A multicentre study of outcome in systemic lupus erythematosus. Arthritis Rheum 25:612–617
Symmons DPM (1995) Occasional series. Lupus around the world. Frequency of lupus in people of African origin. Lupus 4:176–178
Bates WD, Halland AM, Tribe RD et al (1991) Lupus nephritis. Part I. Histopathological classification, activity and chronicity scores. S Afr Med J 79:256–259
Hochberg MC (1997) Updating the American College of Rheumatology revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum 40:1725
Whitelaw DA, Spangenberg JJ, Rickman R et al (1999) The association between the antiphospholipid antibody syndrome and neurological impairment in SLE. Lupus 8:444–448
Raj R, Murin S, Matthay A et al (2002) Systemic lupus erythematosus in the intensive care unit. Crit Care Clin 18:781–803
Nived O, Sturfelt G, Wollheim F (1985) Systemic lupus erythematosus and infection: a controlled and prospective study including an epidemiological group. Q J Med 55:271–287
Breshninan B (1989) Outcome and survival in systemic lupus erythematosus. Ann Rheum Dis 48:443–445
Pu SJ, Luo SF, Wu YJJ et al (2000) The clinical features and prognosis of lupus with disease onset at age 65 and older. Lupus 9:96–100
Staples P, Gerding D, Decker J et al (1974) Incidence of infection in systemic lupus erythematosus. Arthritis Rheum 17:1–10
Duffy KNW, Duffy CM, Gladman DD (1991) Infection and disease activity in systemic lupus erythematosus: a review of hospitalized patients. J Rheumatol 18:1180–1184
Jonsson H, Nived O, Sturfelt G (1989) Outcome in systemic lupus erythematosus: a prospective study in a defined population. Medicine 68:141–150
Ter Borg EJ, Horst G, Limburg PC et al (1990) C-reactive protein levels during disease exacerbations and infections in systemic lupus erythematosus: a prospective longitudinal study. J Rheumatol 17:1642–1648
Morley JJ, Kushner I (1982) Serum C-reactive protein levels in disease. Ann N Y Acad Sci 389:406–418
Jansen NM, Karnad DP, Guntupalli KK (2002) Rheumatic diseases in the intensive care unit: epidemiology clinical outcome, management and outcome. Crit Care Clin 18:729–748
Esdaile JM, Abrahamowicz M, Joseph L et al (1996) Laboratory tests as predictors of disease exacerbations in systemic lupus erythematosus. Arthritis Rheum 39:370–378
About this article
Cite this article
Whitelaw, D.A., Gopal, R. & Freeman, V. Survival of patients with SLE admitted to an intensive care unit—a retrospective study. Clin Rheumatol 24, 223–227 (2005). https://doi.org/10.1007/s10067-004-1007-3
- Intensive care
- Systemic lupus erythematosus