Article

Critical illness polyneuromyopathy (CIPNM) increasingly is recognized
as a source of disability in patients requiring intensive care unit (ICU)
admission. The prevalence and impact of CIPNM on patients in the rehabilitation
setting has not been established. OBJECTIVES: To determine the proportion of
at-risk rehabilitation inpatients with evidence of CIPNM and the functional
sequelae of this disorder. SETTING:
Tertiary academic rehabilitation hospital. PATIENTS: Rehabilitation inpatients
with a history of ICU admission for at least 72 hours. METHODS: Electrodiagnostic
studies were performed to evaluate for axonal neuropathy and/or myopathy in at
least one upper and one lower limb. MAIN OUTCOME MEASUREMENTS: The primary
outcome was prevalence of CIPNM. Secondary outcomes included Functional
Independence Measure (FIM) scores, rehabilitation length of stay (RLOS), and
discharge disposition. RESULTS: A total of 33 participants were enrolled; 70% had
evidence of CIPNM. Admission FIM score, discharge FIM, FIM gain, and FIM
efficiency were 64.1, 89.9, 25.5, and 0.31 in those with CIPNM versus 78.4, 94.6,
16.1, and 0.33 in those without CIPNM, respectively. Average RLOS was 123 days
versus 76 days and discharge to home was 57% versus 90% in the CIPNM and
non-CIPNM groups, respectively. CONCLUSIONS: CIPNM is very common in
rehabilitation inpatients with a history of ICU admission. It was associated with
a lower functional status at rehabilitation admission, but functional improvement
was at a similar rate to those without CIPNM. Longer RLOS stay may be required to
achieve the same functional level. LEVEL OF EVIDENCE: III.
CI - Copyright (c) 2018 American Academy of Physical Medicine and Rehabilitation.
Published by Elsevier Inc. All rights reserved.

Langue : ANGLAIS