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OBJETIVOS: Face à demanda de nosso serviço, buscamos descrever as características e a evolução dos pacientes com lúpus eritematoso sistêmico (LES) internados na unidade de terapia intensiva do Hospital Universitário Walter Cantídio. MÉTODOS: Os pacientes foram, retrospectivamente, caracterizados quanto aos dados demográficos, tempo de diagnóstico da doença, disfunções orgânicas e exames laboratoriais à admissão, suportes terapêuticos usados durante a internação, tempo de internação hospitalar prévio à admissão, tempo de permanência na unidade, reinternações e desfecho evolutivo. Foram avaliados os escores Systemic Lupus Erythematosus Disease Activity (SLEDAI) e Acute Physiological and Chronic Health Evaluation II (APACHE II) à admissão, a mortalidade prevista e a razão de mortalidade padronizada. RESULTADOS: No período de novembro de 2003 a outubro de 2006, 1.052 pacientes foram admitidos à UTI, 50 (4,75%) dos quais com LES. Houve predomínio do sexo feminino (88,2%), com média de idade de 30,3 ± 12,8 anos. A mediana do tempo de diagnóstico da doença foi de 67 meses. As disfunções mais prevalentes à admissão foram: renal (70,6%), cardiovascular (61,8%), respiratória (55,9%) e neurológica (55,9%). As principais disfunções motivadoras da admissão na unidade de terapia intensiva foram: respiratória (38,2%), cardiovascular (29,4%) e neurológica (29,4%). Os tratamentos mais utilizados foram: hemocomponentes (44,1%), fármacos vasopressores (41,2%), ventilação mecânica (35,3%) e diálise (23,5%). A média do SLEDAI foi 15 ± 12,2 pontos e a do APACHE II foi 19,3 ± 6,8 pontos, com mortalidade prevista de 37,6%. Registrou-se óbito de 20,6% após 48 horas na unidade de terapia intensiva e 8,8%, com menos de 48h. A razão de mortalidade padronizada foi 0,78. Os pacientes com APACHE II maior que 18 pontos, com mais de três disfunções orgânicas, leucopenia (menor que 4.000 mm³) e acometimento gastrintestinal ou metabólico faleceram significativamente mais. CONCLUSÃO: A despeito da gravidade à admissão na unidade de terapia intensiva, inferida pelo APACHE II e as disfunções agudas, a evolução dos pacientes analisados sugere susceptibilidade às medidas terapêuticas. OBJECTIVES: Due to the high incidence in our service, we did object on this study describe the features and outcome of patients with systemic lupus erythematosus (SLE) admitted to the intensive care unit of Walter Cantídio University Hospital METHODS: Patients were restrospectively characterized according to demography parameters, time of diagnosis of SLE, organ dysfunction and laboratorial parameters at admission, supportive therapies during their stay, length of stay in the hospital before admission, length of stay in the unit, readmission to the unit and outcome. We also evaluated Systemic Lupus Erythematosus Disease Activity (SLEDAI) score, Acute Physiology and Chronic Health Evaluation II (APACHE II) score, expected mortality and standardized mortality ratio. RESULTS: From November 2003 to October 2006, 1,052 patients were admitted to the intensive care unit. Fifty patients had SLE and were included in this retrospective study. Of the 50 patients with SLE admitted to the ICU, 88.2% were female. The mean age was 30.3 ± 12.8 years. The median time of diagnosis of SLE was 67 months. The most common organ dysfunctions were renal (70.6%), cardiovascular (61.8%), respiratory (55.9%) and neurological (55.9%). The main reasons for admission to the ICU were respiratory (38.2%), cardiologic (29.4%) and neurological (29.4%) dysfunctions. Among the intensive care therapies, 44.1% of the patients needed blood products, 41.2% vasopressor agents and 35.3% mechanical ventilation, 23.5% dialysis. The mean SLEDAI score was 15.0 ± 12.2. The mean APACHE II score was 19.3 ± 6.8, with a predicted mortality rate of 37.6%. The actual mortality rate in ICU was 29.4%, with 8.8% before 48 hours. The standardized mortality ratio was 0.78. Patients with APACHE II > 18, with more than 3 acute organ involvements, leukopenia (< 4000 cells/mm3) and gastrointestinal or metabolic involvement had higher mortality in the intensive care unit. CONCLUSION: Although the severity of patients at admission to the ICU, demonstrated by APACHE II and the acute dysfunctions, the outcomes of analysed patients sugest susceptibility to the therapy

Perfil dos pacientes com lúpus eritematoso sistêmico, internados na unidade de terapia intensiva de um hospital universitário de Fortaleza