Functional independence during hospitalization in patients with intensive care unit-acquired weakness

Abstract

[Purpose] To examine the association between intensive care unit-acquired weakness and functional disability, specifically hospitalization-associated disability. [Participants and Methods] This post-hoc analysis of an investigation of the physical activity of mechanical ventilated patients in intensive care units involved nine hospitals. Consecutive patients, intubated in the intensive care unit for >48 h, were eligible. The exposure variable was intensive-care-unit-acquired weakness. The primary outcomes were the Barthel Index and incidence of hospitalization-associated disability. Multiple logistic regression analysis was used to analyze the association between intensive-care-unit-acquired weakness and both outcomes. [Results] Of the 121 patients, 46 were assigned to the intensive-care-unit-acquired weakness group and 75 to the non-intensive-care-unit-acquired weakness group. The Barthel Index scores were consistently different between intensive care unit discharge and hospital discharge. No significant difference in the incidence of hospitalization-associated disability was found from intensive care unit discharge to 28 days post-ICU discharge. A significant difference between the two groups was observed only at the time of hospital discharge. The Medical Research Council score correlated linearly with the Barthel Index at 7, 14, and 28 days and with hospital discharge. [Conclusion] Intensive-care-unit-acquired weakness is significantly associated with functional disability and hospitalization-associated disability in critically ill patients admitted with acute illness.