de Chambrun MP, Larcher R, Pène F, et al. - Researchers studied critically ill patients with thrombosis and antiphospholipid syndrome (APS), a systemic autoimmune disease defined by thrombotic events, in order to gain insight into their prognoses and in-hospital mortality-associated factors. They conducted a French national, multicenter, retrospective study including 134 patients with 152 APS episodes admitted to 24 ICUs (January 2000-September 2018); the male/female ratio was 0.4; the mean age at admission was 46.0 ± 15.1 years. Outcomes revealed in-hospital mortality of 35 of 134 of their 134 last episodes (26.1%). As per Cox multivariable model, in-hospital mortality was observed to be independently correlated with the following factors: age ≥ 40 years; mechanical ventilation; renal replacement therapy; and in-ICU anticoagulation. For the subgroup of definite/probable catastrophic APS, the Cox bivariable model (including the Simplified Acute Physiology Score II score) retained double therapy (corticosteroids + anticoagulant but not triple therapy (corticosteroids + anticoagulant + IV immunoglobulins or plasmapheresis as independently associated with in-hospital mortality. For all patients, the only APS-specific treatment independently correlated with survival was in-ICU anticoagulation. Patients with definite/probable catastrophic APS exhibited better survival in independent correlation with double therapy.