Impact of ICU-acquired weakness on post-ICU physical functioning: a follow-up study.
Impact of ICU-acquired weakness on post-ICU physical functioning: a follow-up study.
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ICU获得的弱点对ICU后身体功能的影响：一项后续研究。
DOI：
10.1186/s13054-015-0937-2
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发表时间：
2015-04-27
期刊：
影响因子：
--
通讯作者：
van der Schaaf M
中科院分区：
文献类型：
--
作者：
Wieske L;Dettling-Ihnenfeldt DS;Verhamme C;Nollet F;van Schaik IN;Schultz MJ;Horn J;van der Schaaf M
重症监护病房获得性虚弱被认为会导致危重病幸存者的身体损伤，但很少有研究对此进行彻底调查。目的是调查 ICU 出院后 6 个月时有和没有 ICU 获得性无力的患者在 ICU 后死亡率和身体功能的差异。机械通气≥2 天的 ICU 患者被纳入单中心前瞻性观察队列研究。当清醒且注意力集中的患者的医学研究委员会平均评分 <4 时，即可诊断出 ICU 获得性无力。记录 ICU 后死亡率直至 ICU 出院后 6 个月；在幸存的患者中，使用简短健康调查身体功能领域评估身体功能。使用多变量 Cox 比例风险模型分析了 ICU 获得性无力对 ICU 后死亡率的独立影响。使用多变量线性回归模型分析了 ICU 获得性无力对身体功能领域评分的独立影响。在 156 名患者中，80 名患有 ICU 获得性无力。 23 名患者在 ICU 死亡（其中 20 名患者因 ICU 获得性虚弱而死亡）；在 ICU 出院后的 6 个月随访期间，另外 25 名患者死亡（17 名患者因 ICU 获得性虚弱）。 96 名幸存者（39 名患有 ICU 获得性虚弱的患者）获得了身体功能领域评分。 ICU 获得性虚弱与 ICU 后死亡率增加（风险比 3.6，95% 置信区间，1.3 至 9.8；P = 0.01）和身体功能下降独立相关（β：-16.7 点；95% 置信区间，-30.2 至 -3.1；P = 0.02）。 ICU 获得性虚弱与 ICU 出院后 6 个月时幸存者的较高死亡率和临床相关的较低身体功能独立相关。本文的在线版本 (doi:10.1186/s13054-015-0937-2) 包含补充材料，可供授权用户使用。
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. 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. 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). 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. The online version of this article (doi:10.1186/s13054-015-0937-2) contains supplementary material, which is available to authorized users.
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DOI：
10.1056/nejmoa1301372
发表时间：
2013-10-03
期刊：
The New England journal of medicine
影响因子：
--
作者：
Pandharipande PP;Girard TD;Jackson JC;Morandi A;Thompson JL;Pun BT;Brummel NE;Hughes CG;Vasilevskis EE;Shintani AK;Moons KG;Geevarghese SK;Canonico A;Hopkins RO;Bernard GR;Dittus RS;Ely EW;BRAIN-ICU Study Investigators
通讯作者：
BRAIN-ICU Study Investigators
入住重症监护病房前的生活质量是生存的预测指标。
影响因子：
15.1
作者：
Hofhuis, Jose Gm;Spronk, Peter E.;Van Stel, Henk F.;Schrijvers, Augustinus Jp;Bakker, Jan
通讯作者：
Bakker, Jan
影响因子：
8.8
作者：
Fan E;Dowdy DW;Colantuoni E;Mendez-Tellez PA;Sevransky JE;Shanholtz C;Himmelfarb CR;Desai SV;Ciesla N;Herridge MS;Pronovost PJ;Needham DM
通讯作者：
Needham DM
影响因子：
38.9
作者：
De Jonghe, B;Bastuji-Garin, S;Brochard, L
通讯作者：
Brochard, L
影响因子：
76.2
作者：
Hermans, Greet;Casaer, Michael P.;Vanhorebeek, Ilse
通讯作者：
Vanhorebeek, Ilse