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Meta-Analysis
. 2022 Oct 28;101(43):e31405.
doi: 10.1097/MD.0000000000031405.

A systematic review and meta-analysis of risk factors for intensive care unit acquired weakness

Zi Yang  1   2 , Xiaohui Wang  3 , Faying Wang  1   2 , Zeyu Peng  1   2 , Yuying Fan  1   2
Affiliations
Meta-Analysis

A systematic review and meta-analysis of risk factors for intensive care unit acquired weakness

Zi Yang et al. Medicine (Baltimore). .

Abstract

Background: The aim of this meta-analysis is to systematically evaluate and summarize the risk factors of intensive care unit acquired weakness (ICU-AW), to provide evidence-based evidence for the formulation of prevention strategies for ICU-AW.

Methods: PubMed, EMBASE, Web of Science, CBM (China Biology Medicine, China), Chinese National Knowledge Infrastructure, Chinese WANFANG, and VIP will be searched to define relevant risk factors for ICU-AW. The databases search period is from January 1, 2005 to August 13, 2021. The Newcastle Ottawa Scale (NOS) is used to evaluate the quality of the included studies. RevMan 5.3 analysis software will be used for meta-analysis.

Results: This systematic review and meta-analysis included a total of 12 cohort studies, including 9 international journals and 3 Chinese journals, with a total of 1950 patients, of which 856 had ICU-AW. The results showed that the significant risk factors for ICU-AW included female (odds ratio [OR] = 1.34, 95% confidence interval [CI]: 1.06-1.71; P = .02), mechanical ventilation days (OR = 3.04, 95% CI: 1.82-4.26; P < .00001), age (OR = 6.33, 95% CI: 5.05-7.61; P < .00001), length of intensive care unit (ICU) stay (OR = 3.78, 95% CI: 2.06-5.51; P < .0001), infectious disease (OR = 1.67, 95% CI: 1.20-2.33; P = .002), renal replacement therapy (OR = 1.59, 95% CI: 1.11-2.28; P = .01), use of aminoglucoside drugs (OR = 2.51, 95% CI: 1.54-4.08; P = .0002), sepsis related organ failure assessment (SOFA) score (OR = 1.07, 95% CI: 0.24-1.90; P = .01), hyperglycemia (OR = 2.95, 95% CI: 1.70-5.11; P = .0001).

Conclusion: This meta-analysis provides comprehensive evidence-based on the assessment of the risk factors for ICU-AW, their multifactorial etiology was confirmed. This study indicated that female, mechanical ventilation days, age, length of ICU stay, infectious disease, renal replacement therapy, use of aminoglucoside drugs, SOFA score, and hyperglycemia are independent risk factors for ICU-AW. We have not found consistent evidence that corticosteroids, neuromuscular blockers, sepsis have any effect on ICU-AW risk.

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Conflict of interest statement

The authors have no conflicts of interest to disclose.

Figures

Figure 1.
Figure 1.
Study flow diagram.
Figure 2.
Figure 2.
The related risk factors with ICU-AW. ICU-AW = intensive care unit acquired weakness.
Figure 3.
Figure 3.
The meta-analysis results of female.
Figure 4.
Figure 4.
The meta-analysis results of using of aminoglucosides.
Figure 5.
Figure 5.
The meta-analysis results of mechanical ventilation days.
Figure 6.
Figure 6.
The meta-analysis results of age.
Figure 7.
Figure 7.
The meta-analysis results of length of ICU stay. ICU = intensive care unit.
Figure 8.
Figure 8.
The meta-analysis results of renal replacement therapy.
Figure 9.
Figure 9.
The meta-analysis results of infectious disease.
Figure 10.
Figure 10.
The meta-analysis results of SOFA score. SOFA = sepsis related organ failure assessment.
Figure 11.
Figure 11.
The meta-analysis results of using of Corticosteroids.
Figure 12.
Figure 12.
The meta-analysis results of using of neuromuscular blockers.
Figure 13.
Figure 13.
The meta-analysis results of sepsis.
Figure 14.
Figure 14.
The meta-analysis results of hyperglycemia.
Figure 15.
Figure 15.
The meta-analysis results of APACHE II score. APACHE II = Acute Physiology and Chronic Health Evaluation II.
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