What question did this study set out to answer?

The study aims to describe reasons for ICU admission and identify mortality predictors in systemic lupus erythematosus patients.

March 5, 2026

Reasons for ICU admissions and mortality in systemic lupus erythematosus in a South Indian tertiary centre - An observational study.

Key Points

The study aims to describe reasons for ICU admission and identify mortality predictors in systemic lupus erythematosus patients.
Conducted an ambispective observational study in a tertiary care hospital
Included SLE patients admitted to ICU between 2015 and 2021
Collected data on disease characteristics, admission reasons, and outcomes
Used descriptive statistics and logistic regression for analysis
Eighty-seven SLE patients were included with a mean age of 33.16 years, predominantly female (87%)
Common admission causes: high disease activity with infection (48%) and high disease activity alone (39%)
Observed overall mortality rate of 29%, linked primarily to infection and disease activity
Key mortality predictors included APACHE II score, renal replacement therapy, and serum lactate levels

Abstract

BackgroundSystemic lupus erythematosus (SLE) is a chronic autoimmune disease; the course of illness is interspersed with disease flares, infections, adverse drug events which may at times warrant intensive care admission. Reasons for admission and mortality predictors in intensive care units (ICUs) differ globally. This study offers a regional perspective by examining these factors in an Indian context.MethodsThis is a single centre ambispective observational study from a tertiary care hospital in South India. Patients with SLE admitted to ICU due to any cause between 2015 and 2021 were included. The primary objective was to describe reasons for admission to ICU among patients with SLE and secondary objectives were to determine short term mortality rate and factors predicting mortality. Patients' baseline disease characteristics, reason for current hospitalization and final outcome of mortality or discharge from hospital were studied from medical records. Descriptive statistics were used and logistic regression was used to predict in-hospital mortality with different variables.ResultsEighty-seven patients were included in the study. The mean age was 33.16 ± 12.6 years and 87% were female. The most common causes for admission were high disease activity with infection (48%) and high disease activity alone (39%). Mean APACHE II and SLEDAI-2K scores at admission were 17.32 ± 6.42 and 15.16 ± 8.3, respectively. The mean duration of ICU stay was 6.02 ± 6.58 days. The overall mortality rate was 29% with infection and disease activity being major contributors. In the multivariate model excluding cardiac arrest, APACHE II score (OR 1.56, 95% CI: 1.14-2.17, p = 0.010), RRT (OR 7.41, 95% CI: 2.86-20.00, p p = 0.009) emerged as independent predictors of mortality.ConclusionThe leading cause of admission to ICU in our cohort was high disease activity with or without concomitant infection. The mortality rate in our study population was 29%, which is in line with the observed trend in the last 2 decades. APACHE II score at presentation, need for RRT, and baseline serum lactate emerged as independent predictors of ICU mortality.

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Cite This Study

Gopalan et al. (Tue,) studied this question.

synapsesocial.com/papers/69a91db5d6127c7a504c0c5e https://doi.org/https://doi.org/10.1177/09612033261430567

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