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Annals of Intensive Care

Table 2 Characteristics of 121 patients with ARF associated with Svv on ICU admission

From: Causes of acute respiratory failure in patients with small-vessel vasculitis admitted to intensive care units: a multicenter retrospective study

 

All patients n  = 121

Immune ARF n  = 67

Non-immune ARF n  = 54

p

Demographics

 Age, year

62

[50–75]

59

[44–72]

68

[57–76]

0.008

 Male gender, n (%)

75

(62)

38

(57)

37

(69)

0.184

 Diabetes

34

(28)

16

(24)

18

(33)

0.250

 Cardiovascular diseasea, n (%)

63

(52)

27

(40)

36

(67)

0.004

 Respiratory diseaseb, n (%)

36

(30)

14

(21)

22

(41)

0.002

 Immunosuppressionc, n (%)

55

(45)

10

(15)

45

(83)

< 0.0001

 Severe chronic renal failured, n (%)

23

(19)

4

(6)

19

(35)

< 0.0001

Small vessel vasculitis [Svv]

 Etiology of Svv

      

0.358

  GPA

52

(43)

28

(42)

24

(44)

 

  MPA

37

(31)

24

(36)

13

(24)

 

  EGPA

19

(16)

9

(13)

10

(19)

 

  GBM

11

(9)

6

(9)

5

(9)

 

  Unspecified ANCA vasculitis

2

(2)

0

(0)

2

(4)

 

  Time from Svv diagnosis to ICU admission, months

1.5

[0–58]

0

[0–0]

48

[4–132]

< 0.0001

  Svv diagnosis in ICU, n (%)

55

(45)

51

(76)

4

(7)

< 0.0001

  BVAS (Birmingham Vasculitis Activity Score)

15

[1–21]

21

[15–25]

0

[0–9]

< 0.0001

  Revised FFS (Five-factor score)

1

[0–2]

1

[1, 2]

0

[0–1]

0.0004

Clinical presentation upon ICU admission

 Moderate-to-severe ARDS

41

(34)

30

(45)

11

(20)

0.005

 Arterial hypertension

25

(21)

14

(21)

11

(20)

0.943

 Shock

20

(17)

7

(10)

13

(24)

0.045

 Neurological (GCS  ≤ 13)

19

(16)

8

(12)

11

(20)

0.205

 Time from respiratory symptoms to ICU admission, days, n (%)

3

[2–4]

4

[3, 4]

2

[1–3]

0.0002

  < 3 days

45

(38)

16

(24)

29

(54)

0.001

  ≥ 3 days

76

(63)

51

(76)

25

(46)

 

 Extra-respiratory symptomse, n (%)

104

(86)

61

(91)

43

(80)

0.072

 Specific extra-respiratory symptomsf, n (%)

63

(52)

47

(70)

16

(30)

< 0.0001

Laboratory features upon ICU admission

 Hemoglobin, g/dl

9.9

[8–12]

8.8

[7.2–10.8]

11

[8.8–12.4]

0.0012

 Leucocytes, giga/l

13.0

[8.2–16.5]

13.9

[9.2–18.2]

10.7

[7.2–15.6]

0.020

 Plasma creatinine level, µmol/l

200

[88–398]

229

[79–422]

188

[96–300]

0.75

 Hematuria [> 10^4/ ml, n (%)g

54

(45)

44

(66)

10

(19)

< 0.0001

 Positive ANCA and/or GBMg

75

(62)

57

(85)

18

(33)

< 0.0001

Severity criteria upon ICU admission

 SAPS II

39

[27–52]

37

[24–49]

42

[30–54]

0.047

 SOFA

6

[4–8]

6

[3–8]

5.5

[4–8]

0.667

 Vital support administered during the first 48 h, n (%)

  Mechanical ventilation

78

(64)

45

(67)

33

(61)

0.49

  Vasopressors

34

(28)

18

(27)

16

(30)

0.113

  Renal replacement therapy

48

(40)

28

(42)

20

(37)

0.595

  1. Only the first admission was considered for the analysis of the characteristics of immune compared to non-immune ARF. Continuous variables are reported as median [interquartile range (IQR) 25–75]. Categorical variables are reported as number (percentages)
  2. Svv small vessel vasculitis; BVAS Birmingham Vasculitis Activity Score; FFS Five-Factor Score; GPA granulomatosis with polyangiitis; MPA microscopic polyarteritis; EGPA eosinophilic GPA; GBM anti-GBM antibodies disease; ANCA anti-neutrophil cytoplasmic antibodies; GSC Glasgow Coma Scale; SAPSII and SOFA Simplified Acute Physiology Score II and Sequential Organ Failure Assessment score
  3. aArterial hypertension, cardiac failure and/or ischemic heart disease
  4. bCOPD or asthma or interstitial lung disease
  5. cActive cancer, HIV or immunosuppressive treatment
  6. dGlomerular filtration rate  < 30 ml·min-1 over 1 month or more
  7. eFever or asthenia or weight loss
  8. fCutaneous (skin rash, purpura), rheumatic (arthralgia, arthritis, Raynaud’s syndrome, myalgia), neurological, gastrointestinal (abdominal pain, gastrointestinal bleeding), ENT (dysphonia, nasal crusts), lymphadenopathy
  9. gData missing, respectively, for 11 patients and 13 patients (presence of hematuria and auto antibodies)
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