Analysis of risk factors for acquired weakness in ICU patients

Abstract

Listen

Translate article

Objective To analyze risk factors for acquired weakness in ICU patients. Methods Totally 280 patients admitted to the ICU of Nanchong Central Hospital between June 2015 and September 2018 were enrolled. Among them, 63 patients developed ICU acquired weakness, while 217 patients did not. According to clinical work experience, several direct or indirect factors for ICU acquired weakness, such as gender, age, body mass index (BMI), simplified acute physiology score (SAPS) Ⅱ, acute physiology and chronic health evaluation (APACHE) Ⅱ score, disturbance of consciousness, hypertension, hyperglycemia, department, disseminated intravascular coagulation (DIC), sepsis, septic shock, multiple organ dysfunction syndrome (MODS), long-term bed rest and immobilization, hypoalbuminemia, mechanical ventilation time, application of glucocorticoid, neuromuscular blocker and norepinephrine, and early rehabilitation intervention, were included in the Logistic regression analysis to screen out its influencing factors. Results Univariate Logistic regression analysis showed that female [odds ratio (OR)= 1.514, 95% confidence interval (CI) (1.074, 1.328), P= 0.042], age older than 60 [OR= 1.613, 95%CI (1.142, 2.002), P= 0.042], SAPSⅡ score ≥ 25 [OR= 1.982, 95%CI (1.003, 2.925), P= 0.013], APACHEⅡ score ≥ 8 [OR= 1.770, 95% CI (1.192, 2.742), P = 0.014], hyperglycemia [OR = 1.853, 95%CI (1.035, 2.214), P = 0.015], sepsis [OR = 2.309, 95%CI (1.013, 3.063), P = 0.021], septic shock [OR = 2.106, 95%CI (1.995, 4.947), P = 0.025], MODS [OR = 3.721, 95%CI (1.001, 4.980), P = 0.007], long-term bed rest and immobilization [OR = 4.641, 95% CI (1.932, 5.253), P < 0.001], mechanical ventilation time ≥ 72 h [OR = 3.367, 95%CI (1.635, 4.254), P = 0.005], glucocorticoid [OR = 1.709, 95%CI (1.424, 2.757), P = 0.021], neuromuscle blocker [OR = 2.042, 95%CI (1.331, 4.953), P = 0.011], and early rehabilitation intervention [OR = 0.586, 95% CI (0.953, 1.472), P = 0.037] were associated with ICU acquired weakness. After multivariate Logistic regression analysis, age older than 60 [OR = 1.576, 95% CI (1.095, 1.753), P = 0.038], SAPSⅡ score ≥ 25 [OR = 1.988, 95%CI (1.115, 1.803), P = 0.013], APACHEⅡ score ≥8 [OR = 1.768, 95%CI (1.189, 2.364), P = 0.014], hyperglycemia [OR = 1.680, 95%CI (1.033, 1.689), P = 0.015], sepsis [OR = 1.842, 95%CI (1.011, 1.976), P = 0.010], long-term bed rest and immobilization [OR = 4.745, 95%CI (1.931, 3.470), P < 0.001], mechanical ventilation time ≥ 72 h [OR = 3.353, 95%CI (1.722, 4.314), P = 0.003], and neuromuscle blocker [OR = 1.931, 95%CI (1.247, 2.573), P = 0.005] were independent risk factors, and early rehabilitation intervention [OR = 0.598, 95%CI (0.978, 1.674), P = 0.037] was the protective factor for acquired weakness in ICU patients. Conclusions The risk factors of ICU acquired weakness are complex. It is necessary to strengthen early intervention of high-risk patients, actively control blood glucose and reduce immobilization and mechanical ventilation time, thereby preventing the occurrence of ICU acquired weakness. Key words: ICU acquired weakness; Risk factors; Logistic models