AUTHOR: MORAR ANICUȚA IONELA COORDINATOR: COPOTOIU MONICA COAUTHOR: ROMAN NICOLETA GRANCEA IULIA

EPIDEMIOLOGY Rheumatoid arthritis : The most common form of inflammatory joint disease. It occurs in women about three times as frequently as in men. Is considered a disease of the joints, with the synovial membrane of the joint as the seat of the disease process. Can occur at any age, its peak incidence is during the fourth and the sixth decade of life. Its prevalence rises with advancing age.

PURPOSE OF THE STUDY A retrospective and prospective observational study. To evaluate the outcome of the patients diagnosed with rheumatoid arthritis admitted in intensive care unit. Of the 521 patients treated for rheumatic arthritis, only 23 evolved to a critically ill. The variables used to measure the predicted mortality and the severity of the disease were the ICU scores: APACHE II, SOFA, SAPS.

The variables followed were the demographic features as: GENDER AGETHE ONSET OF THE DISEASETHE COMORBIDITIESTHE HOSPITALIZATION DAYSTHE TREATMENTICU PREDICTIVE SCORES

PREDICTIVE SCORES IN INTENSIVE CARE UNIT APACHE II Is scored in the first 24 hours after hospitalization in ICU 12 physiological measurements SAPS Is a severity of disease score Is calculated 24 hours after hospitalization SOFA Is the score use in ICU for organ failure It is performed in the first 48 hours and afterwards

THE REASONS FOR ADMISSION

PATIENTS WHO DIED

The following scores were calculated at admission in Intensive Care Unit for the patients with rheumatoid arthritis ICU SCORES MORTALITY APACHE II 15,41+- 7,38 SOFA 6,52+-3,24 SAPS 41,29+-13,52

THE SCORES WERE CORRELATED WITH: THE TREATMENT THE CAUSE OF DEATH SEPSIS

The only statistically significant correlation appeared to be: SAPS with sepsis for p=0,047 r=0,302 SAPS with demise for p=0,002

Another statistically correlation appeared to be: APACHE II for p=0,01 There was no significant difference between length of stay(12,02 days) in Intensive Care Unit, for survivors or dead : p=0,07

The main cause for the ICU hospitalization of the patients with rheumatoid arthritis was sepsis.

CONCLUSIONS Sepsis is the main cause for the admission of RA patients in the ICU. Corticotherapy, even in low doses, is a predictor for sepsis. The duration of hospitalization wasn’t linked with infections and thus with the outcome of RA patients admitted in the ICU. The mortality remains high in RA patients admitted in ICU

Thank you !