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Outcome of patients having dermatomyositis admitted to the intensive care unit
Yaniv Sherer1, Daniel Shepshelovich, Tamara Shalev
1Department of Medicine B and Center for Autoimmune Diseases, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel. sherery@017.net.il
Abstract:
Patients having systemic rheumatic diseases constitute a small percentage of admissions to the medical intensive care units (ICUs). Dermatomyositis (DM) is one of the rheumatic diseases that have secondary complications that may lead to a critical illness requiring hospitalization in the ICU. Herein, we present the features, clinical course, and outcome of critically ill patients having DM who were admitted to the ICU. The medical records of six DM patients admitted to the ICU in a large tertiary hospital in a 12-year period were reviewed. The mean age of patients at time of admission to the ICU was 38 (range 16-37). Mean disease duration from diagnosis to admission to the ICU was 1.6 years (range 1 month-8 years), while the main reason for admission to the ICU was acute respiratory failure. Two of six patients died during the hospitalization. The main causes of death were respiratory complications and sepsis. The outcome of DM patients admitted to the ICU was generally not different from the outcome of other patients hospitalized in the ICU. The main reason for hospitalization was acute respiratory failure. As there are many reasons for respiratory failure in DM, an early diagnosis and aggressive appropriate treatment may help to further reduce the mortality in these patients.
Insights
Critically ill patients with dermatomyositis (DM) admitted to the ICU often develop acute respiratory failure. Early diagnosis and treatment of respiratory complications in DM patients can improve outcomes.
Area of Science:
- Rheumatology
- Critical Care Medicine
- Pulmonology
Background:
- Systemic rheumatic diseases are uncommon causes for medical intensive care unit (ICU) admission.
- Dermatomyositis (DM) can lead to critical illness requiring ICU care due to secondary complications.
Observation:
- This study reviewed six dermatomyositis patients admitted to the ICU over 12 years.
- The average age was 38, with a mean disease duration of 1.6 years prior to ICU admission.
- Acute respiratory failure was the primary reason for ICU admission.
Findings:
- Two out of six patients died, primarily from respiratory complications and sepsis.
- The overall outcome for DM patients in the ICU was comparable to other ICU patients.
- Acute respiratory failure was the main driver for hospitalization.
Implications:
- Prompt diagnosis and aggressive management of respiratory failure in dermatomyositis are crucial.
- Further research may identify specific interventions to reduce mortality in critically ill DM patients.
- Understanding the critical care needs of dermatomyositis patients can improve management strategies.
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