PMID- 34760903
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20211112
IS  - 2296-858X (Print)
IS  - 2296-858X (Electronic)
IS  - 2296-858X (Linking)
VI  - 8
DP  - 2021
TI  - Predictors of Mortality in Critically Ill Patients With Antineutrophil 
      Cytoplasmic Antibody-Associated Vasculitis.
PG  - 762004
LID - 10.3389/fmed.2021.762004 [doi]
LID - 762004
AB  - Background: Patients with antineutrophil cytoplasmic antibody-associated 
      vasculitis (AAV) may require intensive care unit (ICU) admission due to different 
      reasons, and the in-ICU mortality is high among AAV patients. The aim of this 
      study was to explore the clinical features and risk factors of mortality of 
      patients with AAV in the ICU. Methods: A retrospective study was conducted based 
      on 83 AAV patients admitted to the ICU in a tertiary medical institution in 
      China. Data on clinical characteristics, laboratory tests, treatment in ICU and 
      outcomes were collected. The data were analyzed using univariate and multivariate 
      logistic regression analysis to explore the variables that were independently 
      related to mortality. Kaplan-Meier method was used to assess the long-term 
      survival. Results: Among the 83 patients, 41 (49.4%) were female. The mean age of 
      patients was 66 +/- 13 years. Forty-four patients deceased, with the in-ICU 
      mortality of 53%. The most common cause for ICU admission was active vasculitis 
      (40/83, 48.2%). The main cause of death was infection (27/44, 61.4%) followed by 
      active vasculitis (15/44, 34.1%). A multivariate analysis revealed that the Acute 
      Physiology and Chronic Health Evaluation II (APACHE II) at ICU admission (OR = 
      1.333, 95% CI: 1.031-1.722) and respiratory failure (OR = 620.452, 95% CI: 
      11.495-33490.306) were independent risk factors of in-ICU death. However, 
      hemoglobin (OR = 0.919, 95% CI: 0.849-0.995) was an independent protective 
      factor. The nomogram established in this study was practical in predicting the 
      risk of in-ICU mortality for AAV patients. Moreover, for 39 patients survived to 
      the ICU stay, the cumulative survival rates at 0.5, 1, and 5 years were 58.3%, 
      54.2%, and 33.9%, respectively, and the median survival time was 14 months. 
      Conclusion: In our study, active vasculitis was the most frequent reason for ICU 
      admission, and the main cause of death was infection. APACHE II and respiratory 
      failure were independent risk factors while hemoglobin was an independent 
      protective factor of in-ICU mortality for AAV patients admitted to the ICU. The 
      risk prediction model developed in this study may be a useful tool for clinicians 
      in early recognition of high-risk patients and applying appropriate management.
CI  - Copyright (c) 2021 Zhang, Guo, Zhang, Zhang, Duan, Shi, Guo and Liu.
FAU - Zhang, Yuqi
AU  - Zhang Y
AD  - Department of Rheumatology and Immunology, the First Affiliated Hospital of 
      Zhengzhou University, Zhengzhou, China.
FAU - Guo, Jinyan
AU  - Guo J
AD  - Department of Rheumatology and Immunology, the First Affiliated Hospital of 
      Zhengzhou University, Zhengzhou, China.
FAU - Zhang, Panpan
AU  - Zhang P
AD  - Department of Rheumatology and Immunology, the First Affiliated Hospital of 
      Zhengzhou University, Zhengzhou, China.
FAU - Zhang, Lei
AU  - Zhang L
AD  - Department of Rheumatology and Immunology, the First Affiliated Hospital of 
      Zhengzhou University, Zhengzhou, China.
FAU - Duan, Xiaoguang
AU  - Duan X
AD  - Department of Intensive Care Unit, the First Affiliated Hospital of Zhengzhou 
      University, Zhengzhou, China.
FAU - Shi, Xiaofei
AU  - Shi X
AD  - Department of Rheumatology, the First Affiliated Hospital and College of Clinical 
      Medicine, Henan University of Science and Technology, Luoyang, China.
FAU - Guo, Nailiang
AU  - Guo N
AD  - Department of Rheumatology and Immunology, Xinyang Central Hospital, Xinyang, 
      China.
FAU - Liu, Shengyun
AU  - Liu S
AD  - Department of Rheumatology and Immunology, the First Affiliated Hospital of 
      Zhengzhou University, Zhengzhou, China.
LA  - eng
PT  - Journal Article
DEP - 20211025
PL  - Switzerland
TA  - Front Med (Lausanne)
JT  - Frontiers in medicine
JID - 101648047
PMC - PMC8573203
OTO - NOTNLM
OT  - Acute Physiology and Chronic Health Evaluation II
OT  - antineutrophil cytoplasmic antibody-associated vasculitis
OT  - intensive care unit
OT  - mortality
OT  - nomogram
OT  - predictors
COIS- The authors declare that the research was conducted in the absence of any 
      commercial or financial relationships that could be construed as a potential 
      conflict of interest.
EDAT- 2021/11/12 06:00
MHDA- 2021/11/12 06:01
PMCR- 2021/10/25
CRDT- 2021/11/11 07:01
PHST- 2021/08/20 00:00 [received]
PHST- 2021/09/28 00:00 [accepted]
PHST- 2021/11/11 07:01 [entrez]
PHST- 2021/11/12 06:00 [pubmed]
PHST- 2021/11/12 06:01 [medline]
PHST- 2021/10/25 00:00 [pmc-release]
AID - 10.3389/fmed.2021.762004 [doi]
PST - epublish
SO  - Front Med (Lausanne). 2021 Oct 25;8:762004. doi: 10.3389/fmed.2021.762004. 
      eCollection 2021.