ICU-acquired weakness in critically ill patients at risk of malnutrition: risk factors, biomarkers, and early enteral nutrition impact  

作　　者：Qingliu Zheng Changyun Liu Lingying Le Qiqi Wu Zhihong Xu Jiyan Lin Qiuyun Chen 

机构地区：[1]Department of Emergency Medicine,the First Affi liated Hospital of Xiamen University,Xiamen 361003,China [2]Department of Neurology,Union Hospital Affi liated to Fujian Medical University,Fuzhou 350001,China [3]Department of Neurology,West China Hospital of Sichuan University Xiamen Hospital,Xiamen 361021,China

出　　处：《World Journal of Emergency Medicine》2025年第1期51-56,共6页世界急诊医学杂志(英文)

摘　　要：BACKGROUND: This study aimed to explore the risk factors associated with intensive care unitacquired weakness(ICU-AW) in critically ill patients at risk of malnutrition and to evaluate the efficacy of early enteral nutrition(EEN) and the role of biomarkers in managing ICU-AW.METHODS: This retrospective, observational cohort study included 180 patients at risk of malnutrition admitted to the emergency intensive care unit of the First Affiliated Hospital of Xiamen University Hospital from January 2022 to December 2023. Patients were divided into ICU-AW group and non-ICU-AW group according to whether they developed ICU-AW, or categorized into EEN and parenteral nutrition(PN) groups according to nutritional support. ICU-AW was diagnosed using the Medical Research Council score. The primary outcome was the occurrence of ICU-AW.RESULTS: The significant factors associated with ICU-AW included age, sex, type of nutritional therapy, mechanical ventilation(MV), body mass index(BMI), blood urea nitrogen(BUN), and creatinine(Cr) levels(P<0.05). The PN group developed ICU-AW earlier than did the EEN group, with a significant difference observed(log-rank P<0.001). Among biomarkers for ICU-AW, the mean prealbumin(PAB)/C-reactive protein(CRP) ratio had the highest diagnostic accuracy(area under the curve [AUC] 0.928, 95% confidence interval [95% CI] 0.892–0.946), surpassing the mean Cr/BUN ratio(AUC 0.740, 95% CI 0.663–0.819) and mean transferrin levels(AUC 0.653, 95% CI 0.574–0.733).CONCLUSION: Independent risk factors for ICU-AW include female sex, advanced age, PN, MV, lower BMI, and elevated BUN and Cr levels. EEN may potentially delay ICU-AW onset, and the PAB/CRP ratio may be an effective diagnostic marker for this condition.

关 键 词：Intensive care units Muscular weakness Hospital-acquired condition Enteral nutrition Biomarkers Risk factors 

分 类 号：R73[医药卫生—肿瘤]