Causes of Mortality in Intensive Care Units for Patients with Chronic Inflammatory Diseases from the French National...

Background/Objectives: Inflammatory pathologies are at the center of various medical specialties and benefit from conventional treatments as well as biological treatments. These latter ones have often been the subject of studies yielding heterogeneous results regarding their infectious and mortality risks. This work aims to describe mortality and its causes in patients afflicted by inflammatory pathologies, receiving either conventional or biological therapy during their first stay in intensive care units. Methods: Our study was conducted using the French national health database, encompassing all hospital stays on a national scale. All comparisons between conventional treatment and biological therapies were performed using the Chi-square test, Fisher's exact test, or Student's t-test. Results: In total, 13,816 patients were included. Within 90 days of the first admission to the intensive care/reanimation service, 11.6% of the patients died, including 9.4% within 30 days and 7.3% during hospitalization. More patients died in the conventional treatment group in comparison to the biological treatment group. More deaths were observed due to cardiovascular (27%), infectious (15%), gastroenterological (12%), and oncological (12%) conditions in the conventional treatment group. However, there were as many deaths from oncological causes (19%) as from cardiovascular causes (19%) in the biological therapy group. Hypertension (66.8%) and renal insufficiency (50.4%) were the most frequently associated comorbidities with mortality. Conclusions: Mortality in intensive care/reanimation during the initial stay of patients afflicted by inflammatory pathologies is of greater concern for those treated with conventional treatments. Causes of death tend to be more cardiovascular and require more prevention and care management.