Abstract
INTRODUCTION: ICU-acquired weakness is thought to mediate physical impairments in survivors of critical illness, but few studies have investigated this thoroughly. The purpose was to investigate differences in post-ICU mortality and physical functioning between patients with and without ICU-acquired weakness at 6 months after ICU discharge.
METHOD: ICU patients, mechanically ventilated ≥ 2 days, were included in a single-center prospective observational cohort study. ICU-acquired weakness was diagnosed when the average Medical Research Council score was <4 in awake and attentive patients. Post-ICU mortality was recorded until 6 months after ICU discharge; in surviving patients, physical functioning was assessed using the Short-Form Health Survey physical functioning domain. The independent effect of ICU-acquired weakness on post-ICU mortality was analyzed using a multivariable Cox proportional hazards model. The independent effect of ICU-acquired weakness on the physical functioning domain score was analyzed using a multivariable linear regression model.
RESULTS: Of the 156 patients included, 80 had ICU-acquired weakness. Twenty-three patients died in the ICU (20 with ICU-acquired weakness); during 6 months follow-up after ICU discharge another 25 patients died (17 with ICU-acquired weakness). Physical functioning domain scores were available for 96 survivors (39 patients with ICU-acquired weakness). ICU-acquired weakness was independently associated with an increase in post-ICU mortality (hazard ratio 3.6, 95% confidence interval, 1.3 to 9.8; P = 0.01) and with a decrease in physical functioning (β: -16.7 points; 95% confidence interval, -30.2 to -3.1; P = 0.02).
CONCLUSION: ICU-acquired weakness is independently associated with higher post-ICU mortality and with clinically relevant lower physical functioning in survivors at 6 months after ICU discharge.
Original language | English |
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Article number | 196 |
Pages (from-to) | 196 |
Number of pages | 8 |
Journal | Critical Care |
Volume | 19 |
Issue number | 1 |
DOIs | |
Publication status | Published - 27 Apr 2015 |
Keywords
- Aged
- Aged, 80 and over
- Cohort Studies
- Critical Illness
- Female
- Follow-Up Studies
- Humans
- Intensive Care Units
- Journal Article
- Male
- Middle Aged
- Muscle Weakness
- Observational Study
- Patient Discharge
- Prospective Studies
- Recovery of Function
- Research Support, Non-U.S. Gov't
- Respiration, Artificial
- Survival Rate