Risk factors associated with the death of patients hospitalized for juvenile systemic lupus erythematosus
Título del documento: Risk factors associated with the death of patients hospitalized for juvenile systemic lupus erythematosus
Revista: Brazilian journal of medical and biological research
Base de datos: PERIÓDICA
Número de sistema: 000350926
ISSN: 0100-879X
Autores: 1
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Instituciones: 1Universidade de Sao Paulo, Faculdade de Medicina, Sao Paulo. Brasil
Año:
Periodo: Jul
Volumen: 40
Número: 7
Paginación: 993-1002
País: Brasil
Idioma: Inglés
Tipo de documento: Artículo
Enfoque: Experimental, aplicado
Resumen en inglés We assessed the risk factors associated with death in patients hospitalized for juvenile systemic lupus erythematosus (JSLE) and evaluated the autopsy reports. A total of 57,159 hospitalizations occurred in our institution from 1994 to 2003, 169 of them involving 71 patients with JSLE. The most recent hospitalization of these patients was evaluated. Patients were divided into two groups based on mortality during hospitalization: those who survived (N = 53) and those who died (N = 18). The main causes of hospitalization were JSLE activity associated with infection in 52% and isolated JSLE activity in 44%. Univariate analysis showed that a greater risk of death was due to severe sepsis (OR = 17.8, CI = 4.5-70.9), systemic lupus erythematosus disease activity index (SLEDAI) ³8 (OR = 7.6, CI = 1.1-53.8), general infections (OR = 6.1, CI = 1.5-25), fungal infections (OR = 5.4, CI = 3.2-9), acute renal failure (OR = 5.1, CI = 2.5-10.4), acute thrombocytopenia (OR = 3.9, CI = 1.9-8.4), and bacterial infections (OR = 2.3, CI = 1.2-7.5). Stratified analysis showed that severe sepsis and SLEDAI ³8 were not confounder variables. In the multivariate analysis, logistic regression showed that the only independent variable in death prediction was severe sepsis (OR = 98, CI = 16.3-586.2). Discordance between clinical diagnosis and autopsy was observed in 6/10 cases. Mortality of hospitalized JSLE patients was associated with severe sepsis. Autopsy was important to determine events not detected or doubtful in dead patients and should always be requested
Disciplinas: Medicina
Palabras clave: Inmunología,
Enfermedades autoinmunes,
Lupus eritematoso sistémico,
Sepsis,
Mortalidad,
Factores de riesgo
Keyword: Medicine,
Immunology,
Autoimmune diseases,
Systemic lupus erythematosus,
Sepsis,
Mortality,
Risk factors
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