Risk factors and 6-month outcomes of paediatric intensive care unit-acquired weakness.

BACKGROUND

Intensive care unit-acquired weakness results in adverse prognosis, healthcare costs, and resources. Little is known about paediatric intensive care unit-acquired weakness (PICU-AW).

OBJECTIVE

The goal of this study was to determine risk factors and 6-month outcomes after discharge of patients with PICU-AW.

METHODS

From May 2021 to December 2022, a prospective observational study was conducted in a single centre from China. Children aged 7-18 years were divided into two groups with and without PICU-AW at discharge. A predesigned data form was used to collect patients' characteristics. Risk factors were analysed by univariate and multivariate logistic analyses. Outcomes such as muscle strength, functional status, and health-related quality of life (HRQOL) were assessed at 1, 3, and 6 months after discharge.

RESULTS

A total of 172 patients were assessed for eligibility at discharge, and 44 children (25.6%) were diagnosed with PICU-AW. The presence of systemic inflammatory response syndrome on admission (odds ratio [OR]: 6.482, 95% confidence interval [CI]: 2.245-18.712, p = 0.001), higher Pediatric Logistic Organ Dysfunction 2 score on admission (OR: 1.337, 95% CI: 1.011-1.767, p = 0.041), and longer length of stay in the PICU (OR: 1.222, 95% CI: 1.133-1.318, p < 0.001) were significantly associated with PICU-AW. PICU-AW was an independent risk factor for decreased HRQOL at 1 month (OR: 5.215, 95% CI: 1.147-23.715, p = 0.033) and 3 months (OR: 5.318, 95% CI: 1.759-16.077, p = 0.003) after discharge. PICU-AW was not associated with functional status within 6 months after discharge.

CONCLUSIONS

The presence of systemic inflammatory response syndrome on admission, organ dysfunction on admission, and longer PICU stays were independent risk factors for PICU-AW. PICU-AW was found to be the independent risk factor for decreased HRQOL at 1 and 3 months after discharge. Children with normal baseline function were more likely to recover their functional status after discharge.