-
Observational Study
Impact of Critical Illness Polyneuromyopathy in Rehabilitation: A Prospective Observational Study.
- Cameron J B Cunningham, Heather C Finlayson, William R Henderson, Russell J O'Connor, and Andrew Travlos.
- Department of Medicine and Division of Physical Medicine and Rehabilitation, Vancouver Coastal Health Research Institute, University of British Columbia, Vancouver, BC, Canada.
- PM R. 2018 May 1; 10 (5): 494-500.
BackgroundCritical 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.ObjectivesTo determine the proportion of at-risk rehabilitation inpatients with evidence of CIPNM and the functional sequelae of this disorder.DesignProspective observational study.SettingTertiary academic rehabilitation hospital.PatientsRehabilitation inpatients with a history of ICU admission for at least 72 hours.MethodsElectrodiagnostic studies were performed to evaluate for axonal neuropathy and/or myopathy in at least one upper and one lower limb.Main Outcome MeasurementsThe primary outcome was prevalence of CIPNM. Secondary outcomes included Functional Independence Measure (FIM) scores, rehabilitation length of stay (RLOS), and discharge disposition.ResultsA 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.ConclusionsCIPNM 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 EvidenceIII.Copyright © 2018 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.
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