A comprehensive evidence-based intervention programme significantly reduces intensive care unit-acquired weakness and improves functional recovery: a retrospective analysis
DOI:
https://doi.org/10.2340/jrm.v57.43563Keywords:
ICU-acquired weakness, evidence-based medicine, ICU, before-and-after studyAbstract
Background: Intensive care unit-acquired weakness (ICU-AW) affects 25–50% of critically ill patients, resulting in prolonged hospitalization and impaired functional recovery. Despite recognition of its clinical importance, effective prevention and treatment strategies remain limited.
Objective: To evaluate the efficacy of a comprehensive evidence-based intervention programme on ICU-AW incidence and functional outcomes compared with standard care.
Methods: This retrospective analysis conducted between May 2021 and December 2023 included 420 critically ill patients allocated to either an evidence-based intervention group (n = 200) receiving a structured programme incorporating early mobilization, respiratory rehabilitation, swallowing training, psychological support, and nutritional optimization, or a standard care group (n = 220). Primary outcomes included ICU-AW incidence and hospital length of stay. Secondary outcomes comprised MRC muscle strength scores, nutritional status (Subjective Global Assessment), and functional independence (Barthel Index).
Results: The evidence-based intervention group demonstrated significantly lower ICU-AW incidence (32.5% vs 57.3%, p < 0.001) and shorter hospital stays (18.4 ± 6.2 days vs 25.7 ± 7.8 days, p < 0.001) compared with standard care. Post-intervention MRC scores were significantly higher in the evidence-based intervention group (50.4 ± 5.9 vs 44.2 ± 7.1, p < 0.001), representing a mean improvement of 7.3 points (95% CI: 6.2–8.4) compared with 1.9 points (95% CI: 1.2–2.6) in standard care. Nutritional status improved by at least one SGA grade in 56% of evidence-based intervention patients vs 28.6% of standard care patients (p < 0.001). Barthel Index scores increased substantially more in the evidence-based intervention group (32.3-point increase vs 13.4-point increase, p < 0.001), with 41% achieving scores > 75 compared with 16% in standard care (p < 0.001).
Conclusion: A comprehensive evidence-based intervention programme significantly reduces ICU-AW incidence and improves muscle strength, nutritional status, and functional outcomes in critically ill patients. This multimodal strategy offers promise for alleviating ICU-AW’s burden and warrants broader clinical adoption.
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