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Prognostic factors for short-term mortality in RA patients admitted to ICU

Key clinical point: Nonuse of conventional synthetic disease-modifying antirheumatic drugs (csDMARDs), high updated Charlson’s comorbidity index (CCI), elevated acute physiology and chronic health evaluation (APACHE) II score, and coagulation abnormalities predicted poorer prognosis in patients with rheumatoid arthritis admitted to the intensive care unit (ICU).

Major finding: The 30-day, 90-day, and 1-year mortality rates were 22%, 27%, and 37%, respectively. Factors associated with an increased mortality risk after ICU admission were nonuse of csDMARDs (hazard ratio [HR], 0.413; P = .0229), elevated updated CCI (HR, 1.522; P = .0007), high APACHE II score (HR, 1.045; P = .0008), and extended prothrombin time-international normalized ratio (HR, 2.670; P = .0051). The liver (P = .0004) and renal (P = .0009) disease scores were significantly higher in nonsurvivors vs. survivors.

Study details: The findings are based on a single-center retrospective study of 67 patients (mean age at admission, 68±13 years) with RA (median duration, 14±15 years) admitted to the ICU.

Disclosures: The study was supported by grants from JSPS KAKENHI. The authors declared no conflicts of interest.

Source: Fujiwara T et al. BMC Rheumatol. 2020 Dec 4. doi: 10.1186/s41927-020-00164-1.

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Key clinical point: Nonuse of conventional synthetic disease-modifying antirheumatic drugs (csDMARDs), high updated Charlson’s comorbidity index (CCI), elevated acute physiology and chronic health evaluation (APACHE) II score, and coagulation abnormalities predicted poorer prognosis in patients with rheumatoid arthritis admitted to the intensive care unit (ICU).

Major finding: The 30-day, 90-day, and 1-year mortality rates were 22%, 27%, and 37%, respectively. Factors associated with an increased mortality risk after ICU admission were nonuse of csDMARDs (hazard ratio [HR], 0.413; P = .0229), elevated updated CCI (HR, 1.522; P = .0007), high APACHE II score (HR, 1.045; P = .0008), and extended prothrombin time-international normalized ratio (HR, 2.670; P = .0051). The liver (P = .0004) and renal (P = .0009) disease scores were significantly higher in nonsurvivors vs. survivors.

Study details: The findings are based on a single-center retrospective study of 67 patients (mean age at admission, 68±13 years) with RA (median duration, 14±15 years) admitted to the ICU.

Disclosures: The study was supported by grants from JSPS KAKENHI. The authors declared no conflicts of interest.

Source: Fujiwara T et al. BMC Rheumatol. 2020 Dec 4. doi: 10.1186/s41927-020-00164-1.

Key clinical point: Nonuse of conventional synthetic disease-modifying antirheumatic drugs (csDMARDs), high updated Charlson’s comorbidity index (CCI), elevated acute physiology and chronic health evaluation (APACHE) II score, and coagulation abnormalities predicted poorer prognosis in patients with rheumatoid arthritis admitted to the intensive care unit (ICU).

Major finding: The 30-day, 90-day, and 1-year mortality rates were 22%, 27%, and 37%, respectively. Factors associated with an increased mortality risk after ICU admission were nonuse of csDMARDs (hazard ratio [HR], 0.413; P = .0229), elevated updated CCI (HR, 1.522; P = .0007), high APACHE II score (HR, 1.045; P = .0008), and extended prothrombin time-international normalized ratio (HR, 2.670; P = .0051). The liver (P = .0004) and renal (P = .0009) disease scores were significantly higher in nonsurvivors vs. survivors.

Study details: The findings are based on a single-center retrospective study of 67 patients (mean age at admission, 68±13 years) with RA (median duration, 14±15 years) admitted to the ICU.

Disclosures: The study was supported by grants from JSPS KAKENHI. The authors declared no conflicts of interest.

Source: Fujiwara T et al. BMC Rheumatol. 2020 Dec 4. doi: 10.1186/s41927-020-00164-1.

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Clinical Edge Journal Scan: RA January 2021
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