Highlights
- •Among 28,522 SLE patients admitted in France between 2010 and 2015, 1068 experienced septic shock.
- •Septic shock was severe with 34.6% of case requiring invasive mechanical ventilation and 32.0% renal replacement therapy.
- •The 1-year mortality rate was 43.4%.
- •An associated Sjögren syndrome was the only specific SLE phenotype associated with mortality (HR 1.392[1.021–1.899]).
- •One-year healthcare use of septic shock survivors was not different from the other ICU survivors when matched on severity.
Abstract
Objectives
We aimed to assess the characteristics, outcomes and costs of septic shock complicating
Systemic Lupus Erythematosus (SLE).
Methods
Characteristics of SLE patients experiencing a septic shock in France from 2010 to
2015 were analyzed through the French medico-administrative database. Factors associated
with the 1-year post-admission mortality were analyzed, the crude 1-year survival
of SLE patients experiencing septic shock was compared to those admitted for another
reason, and we compared the 1-year outcome associated with SLE septic shock survival
to a matched SLE ICU control population.
Results
Among 28,522 SLE patients, 1068 experienced septic shock. The 1-year mortality rate
was 43.4%. Independently of the severity, an associated Sjögren syndrome was the only
specific SLE phenotype associated with mortality (HR 1.392[1.021–1.899]). Within one
year, post-septic shock survivors (n = 738) were re-admitted 6.42[17.3] times with total cost of € 14,431[20,444]. Unmatched
analysis showed that the outcome of patients admitted in ICU for septic shock was
poorer than that of patients admitted in ICU or hospital for another disease. However,
1-year healthcare use of septic shock survivors was not different from the other ICU
survivors when matched on severity.
Conclusions
Septic shock is a frequent and severe complication among SLE patients even if it is
not associated with more healthcare use than another episode of same severity.
Keywords
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Article info
Publication history
Published online: April 08, 2019
Accepted:
April 2,
2019
Identification
Copyright
© 2019 The British Infection Association. Published by Elsevier Ltd. All rights reserved.
