Risk factors for critical illness polyneuromyopathy
| Authors | |
|---|---|
| Year of publication | 2005 |
| Type | Article in Periodical |
| Magazine / Source | Journal of Neurology |
| MU Faculty or unit | |
| Citation | |
| Field | Neurology, neurosurgery, neurosciences |
| Keywords | sepsis; polyneuropathies; myopathies; critical illness; risk factors |
| Description | Although numerous clinical, laboratory, and pharmacological variables have been reported as significant risk factors for critical illness polyneuromyopathy (CIPM), there is still no consensus on the aetiology of this condition. Objectives of the study was to assess the clinical and electrophysiological incidence and risk factors for CIPM. A cohort of critically ill patients was observed prospectively for a one-month period and the association between neuromuscular involvement and various potential risk factors was evaluated. Sixty one critically ill patients completed the follow-up (30 women, 31 men, median age 59 years). CIPM development was detected clinically in 17 patients (27.9%) and electrophysi-ologically in 35 patients (57.4%). CIPM was significantly associated with the pres-ence and duration of systemic inflammatory response syndrome and the severity of multiple, respiratory, central nervous, and cardiovascular organ failures. The median duration of mechanical ventilation was significantly longer in patients with CIPM com-pared with those without (16 vs 3 days, p< 0.001). Independent predictors of CIPM obtainable within the 1st week of critical illness were the admission sequential organ failure assessment score (odds ratio [OR], 1.15; 95% confidence interval [CI], 1.02-1.36) , the 1st week total sequential organ failure assessment scores (OR, 1.14; 95% CI, 1.06-1.46) and the 1st week duration of systemic inflammatory response syn-drome (OR, 1.05; 95% CI, 1.01-1.15). They were able to correctly predict the devel-opment of CIPM at the end of the 1st week in about 80% of critically ill cases. In conclusion, the presence and duration of systemic inflammatory response syn-drome and the severity of multiple and several organ failures are associated with in-creased risk of the development of CIPM. |
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