Causes of Mortality in Intensive Care Units for Patients with Chronic Inflammatory Diseases from the French National Health Data System
Abstract
:1. Introduction
2. Materials and Methods
2.1. Treatments of Interest for the Study
2.2. Patient Selection Algorithm
2.3. Statistical Analysis
2.4. Ethics and Data Availability
3. Results
3.1. Population Characteristics
3.2. Patient Characteristics During ICU Stays
3.3. Comparison of Populations According to Treatment Prior to Admission to the Intensive Care Unit
3.4. Analysis of Causes of Death (n = 361)
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
Abbreviations
CEPI-DC | Center for Epidemiology of Medical Causes of Death |
CIP | Presentation Identifier Code |
COPD | Chronic Obstructive Pulmonary Disease |
CTLA-4 | Cytotoxic T-lymphocyte-associated antigen 4 |
ICU | Intensive Care Unit |
ID | Inflammatory Disease |
IL-6 | Interleukin 6 |
JAKi | Janus Kinase Inhibitor |
MTX | Methotrexate |
PMSI | Medicalization of Information Systems Program |
RA | Rheumatoid Arthritis |
SCT | Synthetic conventional therapy |
TNF | Tumor Necrosis Factor |
TNF-i | Tumor Necrosis Factor Inhibitor |
tsDMARD | targeted synthetic disease-modifying antirheumatic drug |
UCD | Dispensing Unit Code |
Appendix A
Variables | Patients Numbers |
---|---|
Conventional treatment | |
Methotrexate | 8749 (63.3%) |
Azathioprine | 1364 (9.9%) |
Mycophenolate Mofetil | 362 (2.6%) |
Sulfasalazine | 284 (2.1%) |
Apremilast | 243 (1.8%) |
Leflunomide | 173 (1.3%) |
Cyclophosphamide | 52 (0.4%) |
Chloroquine | 21 (0.2%) |
Combination of conventional treatments | |
Methotrexate; Mycophenolate mofetil | 4 (<0.1%) |
Azathioprine; Methotrexate | 3 (<0.1%) |
Methotrexate; Sulfasalazine | 2 (<0.1%) |
Apremilast; Methotrexate | 1 (<0.1%) |
Variables | Patients Numbers |
---|---|
Anti-TNF α | 2814 (15.7%) |
Adalimumab | 1428 (10.3%) |
Etanercept | 305 (2.2%) |
Infliximab | 225 (1.6%) |
Golimumab | 179 (1.3%) |
Certolizumab pegol | 47 (0.3%) |
Anti-IL12/23 | |
Ustekinumab | 101 (0.7%) |
Anti-IL17 | 76 (0.6%) |
Secukinumab | 69 (0.5%) |
Ixekizumab | 7 (0.1%) |
Anti-IL1 | |
Anakinra | 56 (0.4%) |
Anti-IL6R | 55 (0.4%) |
Tocilizumab | 54 (0.4%) |
Sarilumab | 1 (<0.1%) |
Anti-CD20 | |
Rituximab | 21 (0.2%) |
Ig-CTLA-4 | |
Abatacept | 10 (0.1%) |
Inhibiteur de JAK (tsDMARD) | 6 (<0.1%) |
Tofacitinib | 5 (<0.1%) |
Baricitinib | 1 (<0.1%) |
Anti-TNF α; traitement conventionnels | 47 (0.3%) |
Adalimumab; Azathioprine | 30 (0.2%) |
Adalimumab; Methotrexate | 6 (<0.1%) |
Infliximab; Azathioprine | 6 (<0.1%) |
Etanercept; Methotrexate | 4 (<0.1%) |
Golimumab; Sulfasalazine | 1 (<0.1%) |
Ig-CTLA-4; traitement conventionnels | |
Abatacept; Methotrexate | 1 (<0.1%) |
Anti-IL6R; traitements conventionnels | |
Tocilizumab; Methotrexate | 1 (<0.1%) |
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Variables | Total Population (n = 13,816) |
---|---|
Patient characteristics | |
Age at inclusion (years) | 63 [50–73] |
Age at ICU admission (years) | 65 [52–75] |
Gender Male | 7307 (52.9%) |
Comorbidities | |
Hypertension | 7381 (68.4%) |
Obesity | 3839 (35.6%) |
Chronic Kidney Disease | 3163 (29.3%) |
Type 1 diabetes | 841 (7.8%) |
Type 2 diabetes | 3110 (28.8%) |
Cancer | 3078 (28.5%) |
Congestive Heart Failure | 2917 (27.0%) |
COPD | 1963 (18.2%) |
Treatment | |
Conventional treatment | 11,014 (79.7%) |
Biologic | 2746 (19.9%) |
tsDMARD | 6 (<0.1%) |
Combination of biological and conventional treatment | 50 (0.4%) |
Indication for treatment (first indication) | |
Rheumatoid arthritis | 2831 (20.5%) |
Crohn’s disease | 2525 (18.3%) |
Ulcerative colitis | 2439 (17.7%) |
Psoriasis | 2116 (15.3%) |
Spondyloarthritis | 1842 (13.3%) |
Giant cell arteritis | 816 (5.9%) |
Lupus | 318 (2.3%) |
Still’s disease | 87 (0.6%) |
Juvenile idiopathic arthritis | 10 (<0.1%) |
Arthropathy in Crohn’s disease | 1 (<0.1%) |
Combiantion of indications | 831 (6.1%) |
Variables | Biologic Treatment (n= 3480) | Conventional Treatment (n= 10,265) | p Value |
---|---|---|---|
Patient characteristics | |||
Age at ICU admission (years) | 56 [42–67] | 68 [56–77] | * |
Gender Male | 2121 (61.0%) | 5145 (50.1%) | * |
Comorbidities | |||
Hypertension | 1263 (36.3%) | 5807 (56.6%) | * |
Obesity | 867 (25%) | 2777 (27.1%) | * |
Chronic Kidney Disease | 517 (14.9%) | 2504 (24.4%) | * |
Type 1 diabetes | 142 (4.1%) | 662 (6.5%) | * |
Type 2 diabetes | 584 (16.8%) | 2374 (23.1%) | * |
Cancer | 529 (15.2%) | 2437 (23.7%) | * |
Congestive Heart Failure | 433 (12.4%) | 2377 (23.2%) | * |
COPD | 335 (9.6%) | 1551 (15.1%) | * |
Inflammatory disease | |||
Rheumatoid arthritis | 209 (6.0%) | 2600 (25.3%) | * |
Crohn’s disease | 1072 (30.8%) | 1450 (14.1%) | * |
Ulcerative colitis | 548 (15.7%) | 1867 (18.2%) | * |
Psoriasis | 558 (16.0%) | 1555 (15.2%)1 | 0.21 |
Spondyloarthritis | 819 (23.5%) | 1009 (9.8%) | * |
Giant cell arteritis | 55 (1.6%) | 760 (7.4%) | * |
Lupus | 4 (0.1%) | 314 (3.1%) | * |
Juvenile idiopathic arthritis | 4 (0.1%) | 6 (<0.1%) | 0.28 |
Still’s disease | 36 (1.0%) | 51 (<0.1%) | * |
Death | |||
Death à +/− 90 days | 275 (7.9%) | 1324 (12.9%) | * |
Death à +/− 30 days | 233 (6.7%) | 1068 (10.4%) | * |
Death during stay | 178 (5.1%) | 832 (8.1%) | * |
Variables | Deceased Patients (n = 1014) | Survivors Patients (n = 12,802) | p Value |
---|---|---|---|
Patient characteristics | |||
Age at inclusion (years) | 71 [61–80] | 62 [49–73] | * |
Age at ICU admission (years) | 73 [63–82] | 64 [51–75] | * |
Gender Male | 579 (57.1%) | 6734 (52.6%) | * |
Last treatment before stay | |||
Conventional treatment | 834 (82.2%) | 9431 (73.7%) | * |
Biologic treatment | 176 (17.4%) | 3304 (25.8%) | * |
Comorbidities | |||
Hypertension | 677 (66.8%) | 6704 (52.4%) | * |
Obesity | 283 (27.9%) | 3556 (27.8%) | 0.93 |
Chronic Kidney Disease | 511 (50.4%) | 2652 (20.7%) | * |
Type 1 diabetes | 82 (8.1%) | 759 (5.9%) | * |
Type 2 diabetes | 304 (30.0%) | 2806 (21.9%) | * |
Cancer | 334 (32.9 %) | 2744 (21.4%) | * |
Congestive Heart Failure | 359 (35.4%) | 2558 (20.0%) | * |
COPD | 215 (21.2%) | 1748 (13.7%) | * |
Treatment indication (excluding multiple indications) | |||
Rheumatoid arthritis | 301 (29.7%) | 2530 (19.8%) | * |
Crohn’s disease | 111 (11.0%) | 2414 (18.9%) | * |
Ulcerative colitis | 127 (12.5%) | 2312 (18.1%) | * |
Psoriasis | 207 (20.4%) | 1909 (14.9%) | * |
Spondyloarthritis | 87 (8.6%) | 1755 (13.7%) | * |
Giant cell arteritis | 97 (9.6%) | 719 (5.6%) | * |
Lupus | 26 (2.6%) | 292 (2.3%) | 0.56 |
Still’s disease | 11 (1.1%) | 76 (0.1%) | 0.06 |
Juvenile idiopathic arthritis | 0 (0%) | 10 (<0.1%) | 1 |
Arthropathy in Crohn’s disease | 0 (0%) | 1 (<0.1%) | 1 |
Other treatments given in the last 15 months | |||
Oral corticosteroids | 749 (7.9%) | 9583 (74.9%) | 0.49 |
Nonsteroidal anti-inflammatory drugs | 626 (61.7%) | 8248 (64.4%) | 0.09 |
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Hamidou, Y.; Sobhy Danial, J.M.; Balcaen, T.; Liabeuf, S.; Laville, S.; Jesson, C.; Bruy, P.A.; Farnos, C.; Doussiere, M.; Goeb, V. Causes of Mortality in Intensive Care Units for Patients with Chronic Inflammatory Diseases from the French National Health Data System. J. Clin. Med. 2025, 14, 2000. https://doi.org/10.3390/jcm14062000
Hamidou Y, Sobhy Danial JM, Balcaen T, Liabeuf S, Laville S, Jesson C, Bruy PA, Farnos C, Doussiere M, Goeb V. Causes of Mortality in Intensive Care Units for Patients with Chronic Inflammatory Diseases from the French National Health Data System. Journal of Clinical Medicine. 2025; 14(6):2000. https://doi.org/10.3390/jcm14062000
Chicago/Turabian StyleHamidou, Yannis, Jean Marc Sobhy Danial, Thibault Balcaen, Sophie Liabeuf, Solène Laville, Claire Jesson, Pierre Antoine Bruy, Camille Farnos, Marie Doussiere, and Vincent Goeb. 2025. "Causes of Mortality in Intensive Care Units for Patients with Chronic Inflammatory Diseases from the French National Health Data System" Journal of Clinical Medicine 14, no. 6: 2000. https://doi.org/10.3390/jcm14062000
APA StyleHamidou, Y., Sobhy Danial, J. M., Balcaen, T., Liabeuf, S., Laville, S., Jesson, C., Bruy, P. A., Farnos, C., Doussiere, M., & Goeb, V. (2025). Causes of Mortality in Intensive Care Units for Patients with Chronic Inflammatory Diseases from the French National Health Data System. Journal of Clinical Medicine, 14(6), 2000. https://doi.org/10.3390/jcm14062000