Global muscle strength but not grip strength predicts mortality and length of stay in a general population in a surgical intensive care unit

Jeanette J. Lee, Karen Waak, Martina Grosse-Sundrup, Feifei Xue, Jarone Lee, Daniel Chipman, Cheryl Ryan, Edward A. Bittner, Ulrich Schmidt, Matthias Eikermann

Research output: Contribution to journalArticlepeer-review

47 Scopus citations

Abstract

Background. Paresis acquired in the intensive care unit (ICU) is common in patients who are critically ill and independently predicts mortality and morbidity. Manual muscle testing (MMT) and handgrip dynamometry assessments have been used to evaluate muscle weakness in patients in a medical ICU, but similar data for patients in a surgical ICU (SICU) are limited. Objective. The purpose of this study was to evaluate the predictive value of strength measured by MMT and handgrip dynamometry at ICU admission for in-hospital mortality, SICU length of stay (LOS), hospital LOS, and duration of mechanical ventilation. Design. This investigation was a prospective, observational study. Methods. One hundred ten patients were screened for eligibility for testing in the SICU of a large, academic medical center. The Acute Physiology and Chronic Health Evaluation (APACHE) II score, diagnoses, and laboratory data were collected. Measurements were obtained by MMT quantified with the sum (total) score on the Medical Research Council Scale and by handgrip dynamometry. Outcome data, including in-hospital mortality, SICU LOS, hospital LOS, and duration of mechanical ventilation, were collected for all participants. Results. One hundred seven participants were eligible for testing; 89% were tested successfully at a median of 3 days (25th-75th percentiles=3-6 days) after admission. Sedation was the most frequent barrier to testing (70.6%). Manual muscle testing was identified as an independent predictor of mortality, SICU LOS, hospital LOS, and duration of mechanical ventilation. Grip strength was not independently associated with these outcomes. Limitations. This study did not address whether muscle weakness translates to functional outcome impairment. Conclusions. In contrast to handgrip strength, MMT reliably predicted in-hospital mortality, duration of mechanical ventilation, SICU LOS, and hospital LOS.

Original languageEnglish (US)
Pages (from-to)1546-1555
Number of pages10
JournalPhysical Therapy
Volume92
Issue number12
DOIs
StatePublished - Dec 2012
Externally publishedYes

ASJC Scopus subject areas

  • Physical Therapy, Sports Therapy and Rehabilitation

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