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© Fabrice Chrétien with Ultrapole, colorized by Jean-Marc Panaud
Cellule souche (en jaune) de muscle squelettique partiellement recouverte par la membrane basale, migrant sur une fibre musculaire (en bleu).
Publication : Critical care medicine

Presence and severity of intensive care unit-acquired paresis at time of awakening are associated with increased intensive care unit and hospital mortality

Scientific Fields
Diseases
Organisms
Applications
Technique

Published in Critical care medicine - 01 Dec 2009

Sharshar T, Bastuji-Garin S, Stevens RD, Durand MC, Malissin I, Rodriguez P, Cerf C, Outin H, De Jonghe B,

Link to Pubmed [PMID] – 19770751

Crit. Care Med. 2009 Dec;37(12):3047-53

OBJECTIVES: To assess whether the presence and severity of intensive care unit-acquired paresis are associated with intensive care unit and in-hospital mortality.

DESIGN: Prospective, observational study.

SETTING: Two medical, one surgical, and one medico-surgical intensive care units in two university hospitals and one university-affiliated hospital.

PATIENTS: A total of 115 consecutive patients were enrolled after > 7 days of mechanical ventilation.

INTERVENTIONS: None.

MEASUREMENTS AND MAIN RESULTS: The Medical Research Council score (from 0-60) was used to evaluate upper and lower limb strength at time of awakening, identified as the ability to follow five commands. Intensive care unit-acquired paresis was defined as a Medical Research Council score <48. Patients were followed-up until hospital discharge. The primary end point was hospital mortality. At awakening, median Medical Research Council score was 41 (interquartile range, 21-52), and 75 (65%) patients had intensive care unit-acquired paresis. Hospital non-survivors had a significantly lower Medical Research Council score at awakening (21 [11-43]) vs. 41 [28-53]; p = .008) and a significantly higher rate of intensive care unit-acquired paresis (85.1% vs. 58.4%; p = .02) compared to survivors. After multivariate risk adjustment, intensive care unit-acquired paresis was independently associated with higher hospital and intensive care unit mortality (odds ratio for hospital mortality, 2.02; 95% confidence interval, 1.03-8.03; p = .048). Each Medical Research Council point decrease was associated with a significantly higher hospital mortality (odds ratio, 1.03; 95% confidence interval, 1.01-1.05; p = .033).

CONCLUSIONS: Both the presence and severity of intensive care unit-acquired paresis at the time of awakening are associated with increased intensive care unit and hospital mortality; the mechanisms underlying this association need further study.

http://www.ncbi.nlm.nih.gov/pubmed/19770751