Critical illness polyneuropathy and myopathy in a rural area in Vietnam

Abstract

Introduction: Critical illness polyneuropathy, myopathy and polyneuromyopathy, grouped under the term CIP/CIM, share several risk factors and are associated with debilitating outcomes.

Objective: To assess the incidence and distribution of CIP/CIM subtypes and evaluate the risk factors and outcomes of CIP/CIM in a rural hospital in Vietnam.

Method: One hundred and thirty three critically ill patients treated more than ten days in the ICU were enrolled. The Medical Research Council (MRC) sum scores and the Overall Neuropathy Limitations Scale (ONLS) score were calculated and risk factors were monitored. Extensive electrodiagnostic investigations were performed to confirm the diagnosis of CIP/CIM.

Results: CIP/CIM was diagnosed in 73 (55%) patients. The distribution of polyneuropathy, myopathy and polyneuromyopathy was 35 (48%), 16 (22%) and 22 (30%), respectively. Independent risk factors included systemic inflammatory response syndrome, shock, and electrolyte disturbances. Compared to patients without CIP/CIM, patients with CIP/CIM experienced a mortality rate of 49% vs. 30%, a length of stay in ICU of 20.3days vs. 14.3days, an ONLS score at day thirty of 4.2 vs. 1.3 and at day ninety of 2.7 vs. 1.8.

Conclusion: The study revealed that the diagnosis of CIP/CIM was associated with significantly poorer outcomes in comparison to controls.

Keywords: Critical illness; Electrodiagnosis; Intensive care unit; Myopathy; Polyneuromyopathy; Polyneuropathy.