Incidence, Time Course and Influence on Quality of Life of Intensive Care Unit-Acquired Weakness Symptoms in Long-Term Intensive Care Survivors

Purpose: Intensive care unit-acquired weakness (ICUAW) can manifest as muscle weakness or neuropathy-like symptoms, with diagnosis remaining a challenge. Uncertainties surround the long-term cause and sequelae. Therefore, the purpose was to assess incidence, time course and long-term influence on quality of life (QoL) of symptoms in ICU survivors Methods: After ethical approval and registration (: DRKS00011593), in a single-center cohort study all patients admitted to the ICU in 2007-2017 in a German university hospital were screened. Out of 1,860 patients (>= 7d ICU care including ventilation support for >= 72 h, at least 6mo-10y after ICU) 636 were deceased, 912 survivors were contacted. Results: 149 former patients (age: 63.5 +/- 13.1y; males: 73%; duration in ICU: 20.8 +/- 15.7d; duration of ventilation: 16.5 +/- 13.7 h; time post-ICU: 4.4 +/- 2.7y, 5-10y: 43%) consented to be interviewed concerning occurrence, duration, recovery and consequences of ICUAW-associated muscle weakness or neuropathy-like symptoms after ICU. In 75% at least 1 persistent or previous symmetrical symptom was reported (myopathy-like muscle weakness: 43%; neuropathy-like symptoms: 13%; both: 44%) and rated as incidence of ICUAW. However, only 18% of participants had received an ICUAW diagnosis by their physicians, although 62% had persistent symptoms up to 10y after ICU (5-10y: 46%). Only 37% of participants reported a complete recovery of symptoms, significantly associated with an initially low number of symptoms after ICU (p< 0.0001), myopathy-like symptoms (p= 0.024), and younger age at the time of ICU admission (55.7 +/- 13.1 vs. 62.6 +/- 10.6y,p< 0.001). ICUAW still impaired the QoL at the time of the interview in 74% of affected survivors, with 30% reporting severe impairment. Conclusion: ICUAW symptoms were disturbingly common in the majority of long-term survivors, indicating that symptoms persist up to 10y and frequently impair QoL. However, only a small number of patients had been diagnosed with ICUAW.

Automated summary

ICUAW symptoms are disturbingly common in the majority of long-term survivors, impairing quality of life significantly, yet only a small number of patients have been diagnosed with ICUAW.