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 .