Journal of critical care · 2025
Recovery of motor functions and cognitive functions in patients with intensive care unit-acquired weakness.
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Aoyama Yusuke, Okazaki Masaki, Suzuki Shogo, Umikawa Mako, Hoshiyama Minoru
Аннотация
PURPOSE: This study aimed to identify factors influencing recovery of activities of daily living (ADLs) in patients with ICU-acquired weakness (ICU-AW) after ICU discharge.
METHODS: A retrospective cohort study was conducted with 65 ICU-AW patients. Data were collected from ICU discharge to four weeks post-discharge. Variables analyzed included age, sex, APACHE-II score, mechanical ventilation duration, and presence of delirium. The primary outcome was ADL recovery. Multiple regression analysis was performed using data at ICU discharge, and a linear mixed model assessed changes in motor Functional Independence Measure (FIM) scores.
RESULTS: Median age was 61 years (IQR: 50-70), with females comprising 44.6 %. Median APACHE-II score was 25 (IQR: 20-29), and 69.2 % were surgical ICU patients. Median mechanical ventilation duration was 19 days (IQR: 10-34), and delirium lasted a median of three days (IQR: 1-7). Multivariable analysis showed cognitive FIM score at ICU discharge (β = 19.12, p = 0.001) and delirium duration (β = -9.83, p < 0.001) were independently associated with ADL recovery. The linear mixed model revealed a significant difference in motor FIM gain between patients with preserved cognition and those with cognitive dysfunction (p = 0.001).
CONCLUSIONS: Cognitive function at ICU discharge and delirium duration significantly predicted ADL recovery. These factors should be considered in post-ICU rehabilitation planning.
METHODS: A retrospective cohort study was conducted with 65 ICU-AW patients. Data were collected from ICU discharge to four weeks post-discharge. Variables analyzed included age, sex, APACHE-II score, mechanical ventilation duration, and presence of delirium. The primary outcome was ADL recovery. Multiple regression analysis was performed using data at ICU discharge, and a linear mixed model assessed changes in motor Functional Independence Measure (FIM) scores.
RESULTS: Median age was 61 years (IQR: 50-70), with females comprising 44.6 %. Median APACHE-II score was 25 (IQR: 20-29), and 69.2 % were surgical ICU patients. Median mechanical ventilation duration was 19 days (IQR: 10-34), and delirium lasted a median of three days (IQR: 1-7). Multivariable analysis showed cognitive FIM score at ICU discharge (β = 19.12, p = 0.001) and delirium duration (β = -9.83, p < 0.001) were independently associated with ADL recovery. The linear mixed model revealed a significant difference in motor FIM gain between patients with preserved cognition and those with cognitive dysfunction (p = 0.001).
CONCLUSIONS: Cognitive function at ICU discharge and delirium duration significantly predicted ADL recovery. These factors should be considered in post-ICU rehabilitation planning.