Septic shock among patients with systemic lupus erythematosus: Short and long-term outcome. Analysis of a French nationwide database

Objectives: We aimed to assess the characteristics, outcomes and costs of septic shock complicating Systemic Lupus Erythematosus (SLE). Methods: Characteristics of SLE patients experiencing a septic shock in France from 2010 to 2015 were analyzed through the French medico-administrative database. Factors associated with the 1-year post-admission mortality were analyzed, the crude 1-year survival of SLE patients experiencing septic shock was compared to those admitted for another reason, and we compared the 1-year outcome associated with SLE septic shock survival to a matched SLE ICU control population. Results: Among 28,522 SLE patients, 1068 experienced septic shock. The 1-year mortality rate was 43.4%. Independently of the severity, an associated Sjogren syndrome was the only specific SLE phenotype associated with mortality (HR 1.392[1.021-1.899]). Within one year, post-septic shock survivors (n = 738) were re-admitted 6.42[17.3] times with total cost of (sic) 14,431[20,4 4 4]. Unmatched analysis showed that the outcome of patients admitted in ICU for septic shock was poorer than that of patients admitted in ICU or hospital for another disease. However, 1-year healthcare use of septic shock survivors was not different from the other ICU survivors when matched on severity. Conclusions: Septic shock is a frequent and severe complication among SLE patients even if it is not associated with more healthcare use than another episode of same severity. (C) 2019 The British Infection Association. Published by Elsevier Ltd. All rights reserved.