Álvarez MP, Martínez ZR, Tello VA, Cerón DU, Sierra UA

Language: Spanish
References: 23
Page: 156-162
PDF size: 117.04 Kb.

ABSTRACT

Background: The relationship between critical illness polyneuropathy and myopathy (CIP and CIM) and outcome independently of the main diagnosis has not been described.
Objective: To determine the impact of CIP and CIM in critically ill patient mortality and describe the neurophysiologic findings.
Patients and methods: Design: descriptive, retrospective and prospective preliminary cohort. Setting: the ICU of a teaching hospital. Patients: those with needle electromyography (EMG) and a four limb motor and sensory nerve conduction study (NCS4) who were admitted to the ICU between January 2000 and March 2006 and met CIP and CIM neurophysiologic criteria. Statistics: the observed and predicted mortality was compared with two mathematical models: MPM II-0 and APACHE II using chi-square and the Standardized Mortality Ratio (SMR) with a 95% confidence interval.
Results: Twenty-one of 31 patients with nEMG and NCS4 met CIP and CIM criteria. The observed vs predicted mortality was 52.4 vs 36.1% (p › 0.1), SMR 1.45 (IC 95%: 0.72 a 1.95) for MPM II-0 (n = 21) and 57.1 vs 39.9% (p›0.1), SMR 1.43 (IC 95%: 0.61 a 2.82) for APACHE II (n = 14). Axonal plus demielinizating neuropathy was the most common finding (62%), with associated myopathy in one third of all cases.
Conclusions: The observed mortality in patients with CIP and CIM was greater than the predicted by MPM II-0 and APACHE II. There’s no statistic significance because of the poor sample power. A multivariate analysis with a bigger sample size is necessary to formulate more ascertained conclusions.

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