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Factors associated with infection amongst paediatric patients with systemic lupus erythematosus treated in the intensive care unit.
Restrepo-Escobar, M; A Ríos, N; Hernández-Zapata, L J; Velásquez, M; Eraso, R.
Afiliação
  • Restrepo-Escobar M; 1 University of Antioquia, Medellín, Colombia.
  • A Ríos N; 2 Pablo Tobón Uribe Hospital, Medellín, Colombia.
  • Hernández-Zapata LJ; 1 University of Antioquia, Medellín, Colombia.
  • Velásquez M; 1 University of Antioquia, Medellín, Colombia.
  • Eraso R; 3 San Vicente Fundación University Hospital, Medellín, Colombia.
Lupus ; 28(9): 1141-1147, 2019 Aug.
Article em En | MEDLINE | ID: mdl-31256746
OBJECTIVE: To identify determinants and outcomes associated with infection in paediatric systemic lupus erythematosus (SLE) patients at admission and during hospitalization in intensive care units (ICUs). PATIENTS AND METHODS: A retrospective cohort study of paediatric SLE patients admitted to two ICUs was conducted. Frequency and risk factors of infection as well as mortality were studied. RESULTS: Seventy-three infection episodes amongst 55 patients were analysed. The median age was 14.4 years (IQR 12.5-16). The median SLEDAI was 16 (IQR 12-20). Twenty-nine episodes were documented at admission; the CRP was higher in these patients (6.58 versus 1.04 mg/dl, p<0.001) than in non-infected patients, even after multivariate adjustment (OR 8.6, 95% CI = 2.1-34.8, p = 0.003). Twenty-five (34.7%) episodes occurred during hospitalization. Lupus activity (OR 1.14, 95% CI = 1.01-1.27, p = 0.029), cyclophosphamide (OR 17.9, 95% CI = 2-156, p = 0.009) and mechanical ventilation (OR 16, 95% CI = 2.1-122, p = 0.008) were associated with infection. Ten episodes (14%) led to death. Admission to the ICU due to infection was strongly associated with mortality (90% versus 31.8%, OR 19.4, 95% CI = 2.3-163, p = 0.006). CONCLUSION: In paediatric lupus patients admitted to the ICU, elevated CRP should alert clinicians to possible infection. During hospitalization, SLE activity and cyclophosphamide were associated with infection. Infection at admission to the ICU was strongly associated with mortality.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Hospitalização / Infecções / Unidades de Terapia Intensiva / Lúpus Eritematoso Sistêmico Tipo de estudo: Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Adolescent / Adult / Female / Humans / Male Idioma: En Revista: Lupus Assunto da revista: REUMATOLOGIA Ano de publicação: 2019 Tipo de documento: Article País de afiliação: Colômbia País de publicação: Reino Unido
Texto completo
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Hospitalização / Infecções / Unidades de Terapia Intensiva / Lúpus Eritematoso Sistêmico Tipo de estudo: Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Adolescent / Adult / Female / Humans / Male Idioma: En Revista: Lupus Assunto da revista: REUMATOLOGIA Ano de publicação: 2019 Tipo de documento: Article País de afiliação: Colômbia País de publicação: Reino Unido