Causes of Mortality in ICU-Acquired Weakness

J Intensive Care Med. 2020 Mar;35(3):293-296. doi: 10.1177/0885066617745818. Epub 2017 Dec 14.

Abstract

Background: Intensive care unit-acquired weakness (ICU-AW) is a common complication of critical illness and is associated with increased mortality, longer mechanical ventilation and longer hospital stay. Little is known about the causes of mortality in patients with ICU-AW. In this study, we aimed to give an overview of the causes of death in a population diagnosed with ICU-AW during hospital admission.

Methods: Data from a prospective cohort study in the mixed medical-surgical ICU of the Academic Medical Center in Amsterdam were used. Patients were included when mechanically ventilated for more than 48 hours. Intensive care unit-acquired weakness was defined as a mean medical research council score <4. Baseline data and data on the time of death were collected.

Results: Fifty-three patients were included. Irreversible shock with multiple organ failure (MOF) was the most common cause of death (28/53 of patients; 26 patients with septic shock and 2 patients with hypovolemic shock). Most common site of sepsis was abdominal (38.5%) and pulmonary (19.2%). On admission to the ICU, 53% had a do-not-resuscitate code. In 74% of the patients, further treatment limitations were implemented during their ICU stay.

Conclusion: In this cohort of patients with ICU-AW, most patients died of irreversible shock with MOF, caused by sepsis.

Keywords: ICU-acquired weakness; mortality; weakness.

Publication types

  • Evaluation Study

MeSH terms

  • Aged
  • Cause of Death*
  • Critical Illness
  • Female
  • Frailty / etiology
  • Frailty / mortality*
  • Hospital Mortality
  • Humans
  • Intensive Care Units
  • Male
  • Middle Aged
  • Multiple Organ Failure / etiology
  • Multiple Organ Failure / mortality*
  • Netherlands / epidemiology
  • Prospective Studies
  • Risk Factors
  • Sepsis / etiology
  • Sepsis / mortality*
  • Shock, Septic / etiology
  • Shock, Septic / mortality*