Description

Diffuse alveolar hemorrhage (DAH) can occur in patients with systemic lupus erythematosus. Martinez-Martinez et al identified risk factors associated with increased mortality in patients with SLE-related DAH. The authors are from multiple hospitals in Mexico and the Mayo Clinic in Jacksonville.


 

Patient selection: SLE with diffuse alveolar hemorrhage

 

Risk factors associated with increased mortality:

(1) elevated APACHE II score

(2) need for mechanical ventilation (respiratory failure, odds ratio 15)

(3) renal failure (which may be due to lupus nephritis, odds ratio 4.9)

(4) bacterial and/or fungal infection (odds ratio 3.2)

(5) thrombocytopenia (odds ratio 4.3)

 

where:

• The mean APACHE II for survivors was 16 with range 12 to 21.

• The mean APACHE II for nonsurvivors was 23 with range 16 to 24 (which suggests that most patients had scores of 23 or 24).

• An APACHE II score >= 20 will be used to indicate increased risk.

 


To read more or access our algorithms and calculators, please log in or register.