eISSN: 1731-2531
ISSN: 1642-5758
Anaesthesiology Intensive Therapy
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4/2020
vol. 52
 
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abstract:
Original paper

ANCA-associated vasculitis patients treated in Polish intensive care units – retrospective characteristics based on the POLVAS registry

Anna Włudarczyk
1
,
Grzegorz Biedroń
2
,
Krzysztof Wójcik
2
,
Zbigniew Zdrojewski
3
,
Anna Masiak
3
,
Zenobia Czuszyńska
3
,
Maria Majdan
4
,
Radosław Jeleniewicz
4
,
Magdalena Krajewska
5
,
Mariusz Kusztal
5
,
Marek Brzosko
6
,
Iwona Brzosko
6
,
Alicja Dębska-Ślizień
7
,
Hanna Storoniak
7
,
Witold Tłustochowicz
8
,
Joanna Kur-Zalewska
8
,
Andrzej Rydzewski
9
,
Marta Madej
10
,
Anna Hawrot-Kawecka
11
,
Małgorzata Stasiek
12
,
Eugeniusz J. Kucharz
13
,
Jacek Musial
2
,
Wojciech Szczeklik
1

1.
Department of Intensive Care and Perioperative Medicine, Jagiellonian University Medical College, Kraków, Poland
2.
2nd Department of Internal Medicine, Jagiellonian University Medical College, Krakow, Poland
3.
Department of Internal Medicine, Connective Tissue Diseases, and Geriatrics, Medical University of Gdansk, Gdansk, Poland
4.
Department of Rheumatology and Connective Tissue Diseases, Medical University of Lublin, Lublin, Poland
5.
Department of Nephrology and Transplantation Medicine, Wroclaw Medical University, Wroclaw, Poland
6.
Department of Rheumatology and Internal Diseases, Pomeranian Medical University in Szczecin, Szczecin, Poland
7.
Department of Nephrology, Transplantology, and Internal Diseases, Medical University of Gdansk, Gdansk, Poland
8.
Department of Internal Medicine and Rheumatology, Military Institute of Medicine, Warszawa, Poland
9.
Department of Internal Medicine, Nephrology, and Transplantology, Central Clinical Hospital of the Ministry of the Interior and Administration, Warszawa, Poland
10.
Department of Rheumatology and Internal Medicine, Wroclaw Medical University, Wroclaw, Poland
11.
Department of Internal Medicine and Metabolic Diseases, Medical University of Silesia, Katowice, Poland
12.
Department of Rheumatology, National Institute of Geriatrics, Rheumatology, and Rehabilitation, Warszawa, Poland
13.
Department of Internal Medicine, Rheumatology, and Clinical Immunology, Medical University of Silesia, Katowice, Poland
Anaesthesiol Intensive Ther 2020; 52, 4: 281–286
Online publish date: 2020/10/30
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Introduction
ANCA-associated vasculitides (AAV) is a group of rare disorders where inflammation and damage of the small blood vessels lead to dysfunction of the supplied organs. In severe flares of the disease patients may require intensive care unit (ICU) admission and treatment. The study aims to characterize Polish patients with AAV who were admitted to the ICU and compare them to the others.

Material and methods
An observational, retrospective study based on the POLVAS – registry of Polish adult patients with AAV was carried out. Patients admitted to the ICU (ICU group) were identified and compared with the patients who did not require ICU admission (non-ICU group). Characteristics and comparison between groups were made using standard statistic descriptive methods.

Results
30 patients admitted to the ICU were identified among 573 cases included in the registry. All patients in the ICU group with available data were ANCA positive. The clinical manifestations related to the ICU admission were respiratory, renal and central nervous system involvement. The treatment regimen for remission induction was similar in both groups. Almost half of the patients in the ICU-group (48.3%) required dialysis, whereas in the non-ICU group it was 21.8% (P = 0.01). Infections were also more frequent in the ICU group (72.4% vs. 36.9% P < 0.001). The mortality rate among patients who needed ICU treatment was significantly higher when compared to the rest of the patients (53.6% vs. 7.8%; P < 0.001).

Conclusions
In the Polish AAV cohort one in twenty patients required ICU admission. This group was characterized by multiple organ involvement and high mortality.

keywords:

autoimmune diseases, vasculitis, intensive care unit, ANCA, ICU, AAV

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