Document Detail


Predicting outcome and survival in patients with Wegener's granulomatosis treated on the intensive care unit.
MedLine Citation:
PMID:  17476618     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: This study was designed to search for risk factors predicting mortality of patients with Wegener's granulomatosis (WG) treated on the intensive care unit (ICU). METHODS: Seventeen patients admitted to the ICU of an University Hospital for an acute illness related to WG were analysed retrospectively over 4 years. A variety of clinical and laboratory variables were recorded. Contingency table analyses, univariate logistic regression, and discriminate analysis were performed to determine which factors influenced a negative outcome. RESULTS: Reasons for ICU admission were respiratory failure (n = 10), severe haemoptysis (n = 13), sepsis (n = 9), acute renal failure (n = 6), and gastrointestinal bleeding (n = 1). Patients were treated for a median of 6 days (range 4-121 days). During the stay in the ICU, five patients died within 24-121 days (overall mortality 29.4%). Causes of death were cerebral haemorrhage (n = 2), pulmonary embolism (n = 1), and sepsis (n = 2). Significantly associated with death were: Acute Physiology and Chronic Health Evaluation II (APACHE II) score>24 [p = 0.004, odds ratio (OR) 0.568, 95% confidence interval (CI) 0.327-0.989], period of time in the ICU>10 days (p = 0.001, OR 0.795, 95% CI 0.589-1.072), and treatment with cyclophosphamide during the stay in the ICU (p = 0.013, OR 0.799, 95% CI 0.651-0.980). No association was found for higher age, C-reactive protein (CRP), pulmonary involvement, serum creatinine, and requirement of haemodialysis. CONCLUSIONS: The prognosis for WG patients in the ICU is serious, but the majority can survive. To achieve a more favourable outcome, patients should stay in the ICU for as short a time as possible. The occurrence of renal failure did not influence the outcome in our patients.
Authors:
O Burkhardt; T Köhnlein; E Wrenger; A Lux; K-H Neumann; T Welte
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Scandinavian journal of rheumatology     Volume:  36     ISSN:  0300-9742     ISO Abbreviation:  Scand. J. Rheumatol.     Publication Date:    2007 Mar-Apr
Date Detail:
Created Date:  2007-05-03     Completed Date:  2007-06-28     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0321213     Medline TA:  Scand J Rheumatol     Country:  Norway    
Other Details:
Languages:  eng     Pagination:  119-24     Citation Subset:  IM    
Affiliation:
Department of Pulmonary, Hannover Medical School, Hannover, Germany.
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MeSH Terms
Descriptor/Qualifier:
APACHE
Adult
Aged
Female
Germany / epidemiology
Hospitalization
Humans
Intensive Care Units*
Logistic Models
Male
Middle Aged
Odds Ratio
Prognosis
Retrospective Studies
Survival Analysis
Wegener Granulomatosis / complications,  mortality*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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