Fatemi A, et al. – This study was meant to evaluate the course, outcome, and determinants of mortality in patients with systemic lupus erythematosus (SLE) in intensive care unit (ICU). The main predictors of death in patients with SLE were high Acute Physiologic and Chronic Health Evaluation II (APACHE II), septic shock, and duration of mechanical ventilation. However, more likewise studies were required to draw a fine picture of SLE behavior in ICU.

• This study enrolled SLE patients admitted to ICU from 2004 to 2015. 
• Demographic data, disease characteristics, causes of admission, baseline SLE disease activity index-2K (SLEDAI-2K) and Acute Physiologic and Chronic Health Evaluation II (APACHE) score, the outcome, and the causes of death were recorded.
• By Cox regression analysis, predictors of mortality were compared between alive and dead patients. 
• 94 patients with SLE were enrolled.
• 29.6 years was the mean age at the time of ICU admission.
• Average scores of SLEDAI and APACHE II were 11.3 and 19.8, respectively.
• Pneumonia, diffuse alveolar hemorrhage (DAH), and seizure were the most common causes of ICU admission.
•  47 patients (50%) died in ICU.
• Septic shock (25.5%), multi-organ failure (12.5%), DAH (10.6%), and pneumonia (10.6%) were the principal causes of death.
• After multivariate analysis, high APACHE II, septic shock, and duration of mechanical ventilation were indicators of survival outcome. 
• Mean (95% CI) survival days in ICU in patients with and without respiratory failure were 14.6 (10.4–18.9) and 28.7 (17.9–39.5) days, respectively (P = 0.001).
•  This figure for those with and without septic shock was 13.5 (4.9–11.1) and 22.3 (9.3–24.7) days, respectively (P = 0.016).