Acute Outcomes and 1-Year Mortality of Intensive Care Unit–acquired Weakness. A Cohort Study and Propensity-matched Analysis

• DOI: 10.1164/rccm.201312-2257oc
• Publication Date: 2014-05-13T20:10:27Z
• Authors: Greet Hermans; Helena Van Mechelen; Beatrix Clerckx; Tine Vanhullebusch; Dieter Mesotten; Alexander Wilmer; Michael P. Casaer; Philippe Meersseman; Yves Debaveye; Sophie Van Cromphaut; Pieter J. Wouters; Rik Gosselink; Greet Van den Berghe
• Keywords: Male; Critical Care; Critical Illness; costs and cost analysis; Severity of Illness Index; Cohort Studies; Risk Factors; 0502 economics and business; critical illness; Humans; Prospective Studies; muscle weakness; Aged; Proportional Hazards Models; Muscle Weakness; 05 social sciences; Health Care Costs; Length of Stay; Middle Aged; mortality; Respiration, Artificial; 3. Good health; Patient Outcome Assessment; Intensive Care Units; muscle strength; Female

Intensive care unit (ICU)-acquired weakness is a frequent complication of critical illness. It unclear whether it marker or mediator poor outcomes.To determine acute outcomes, 1-year mortality, and costs ICU-acquired among long-stay (≥8 d) ICU patients to assess the impact recovery at discharge.Data were prospectively collected during randomized controlled trial. Impact on outcomes was analyzed with one-to-one propensity-score-matching for baseline characteristics, illness severity, risk factor exposure before assessment. Among weak patients, persistent discharge death after 1 year examined multivariable Cox proportional hazards analysis.A total 78.6% admitted surgical ICU; 227 415 (55%) assessable weak; 122 matched not-weak patients. As compared had lower likelihood live weaning from mechanical ventilation (hazard ratio [HR], 0.709 [0.549-0.888]; P = 0.009), (HR, 0.698 [0.553-0.861]; 0.008) hospital 0.680 [0.514-0.871]; 0.007). In-hospital per patient (+30.5%, +5,443 Euro patient; 0.04) mortality (30.6% vs. 17.2%; 0.015) also higher. The 105 (46%) not matchable even worse prognosis higher costs. further increased if persisted more severe as (P < 0.001).After careful matching data suggest that worsens morbidity increases healthcare-related mortality. Persistence severity Clinical trial registered www.clinicaltrials.gov (NCT 00512122).