In press. Factors associated with mortality in patients with autoimmune diseases admitted to an intensive care unit between 2014 and 2023

Background: Autoimmune diseases can lead to severe complications requiring admission to the ICU. Previous studies have shown variations in mortality and associated risk factors. Objectives: To determine the factors associated with mortality in patients with autoimmune diseases admitted to the ICU in a high complexity institution in Medellin, Colombia. Methodology: A retrospective cohort study was conducted with patients admitted to the ICU between 2014 and 2023. Patients older than 18 years with a diagnosis of autoimmune disease were included. Sociodemographic and clinical variables and clinical outcomes were analyzed. Results: A total of 104 patients were included, most of them women (n = 93, 89.4%). Infections were the main cause of admission to the ICU (n = 68, 65.4%), especially in patients with rheumatoid arthritis (75%). Pulmonary (n = 60, 57.7%), and renal (n = 34, 32.7%) dysfunction were the most frequent. In-hospital mortality was 18.3%. Risk factors associated with higher mortality were age ≥ 45 years, use of vasopressors, organ dysfunction and history of cancer. Conclusions: Age, pulmonary dysfunction, history of cancer and the need for vasopressors are key factors in the mortality of patients with autoimmune diseases in ICU. Multidisciplinary management and close follow-up are crucial to improve clinical outcomes.