Observational studyIntensive care medicine2020
Five-year impact of ICU-acquired neuromuscular complications: a prospective, observational study.
Observational study in Intensive care medicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 4 registered trials, which are not on this map. Cited by 100 papers, 5 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Impact of Early Parenteral Nutrition Completing Enteral Nutrition in Adult Critically Ill Patients
Assessment of Quality of Life in Patients Who Participated in the Promorea 1 Study
Body Impedance Analysis to Detect Muscle Strength Associated With ICU Acquired Weakness
An Observational Study on Rehabilitation Practices in the ICU for Critically Ill Patients Undergoing Invasive Mechanical Ventilation - Report (REPOrt)
Who cites it
100 citing papers in PubMed, 5 syntheses or guidelines pooled it, 208 citations in OpenAlex.
- The intensive care medicine research agenda for the management of ICU acquired weakness: a multinational, interprofessional perspective.Intensive care medicine · 2025Pooled it
- Growth differentiation factor-15 as a biomarker for intensive care unit-acquired weakness: a meta-analysis.Frontiers in medicine · 2025Pooled it
- Guideline on multimodal rehabilitation for patients with post-intensive care syndrome.Critical care (London, England) · 2023Guideline
- The rate and assessment of muscle wasting during critical illness: a systematic review and meta-analysis.Critical care (London, England) · 2023Pooled it
- ICU-acquired weakness.Intensive care medicine · 2020Pooled it
- Individualised treatment effects of enhanced early mobilisation in mechanically ventilated patients: a secondary analysis of the TEAM trial.Intensive care medicine · 2026Trial
- Altered muscle transcriptome as molecular basis of long-term muscle weakness in survivors from critical illness.Intensive care medicine · 2025Trial
- Impact of withholding early parenteral nutrition on 2-year mortality and functional outcome in critically ill adults.Intensive care medicine · 2024Trial
- DNA methylation alterations in muscle of critically ill patients.Journal of cachexia, sarcopenia and muscle · 2022Trial
- Persisting neuroendocrine abnormalities and their association with physical impairment 5 years after critical illness.Critical care (London, England) · 2021Trial
- Diagnostic Performance of the Strength-Duration Test for Bedside Screening of Critical Illness Polyneuropathy and/or Myopathy: A Prospective, Cross-Sectional Study.Muscle & nerve · 2026Article
- Burden of and risk factors for neurological complications in critical illness.Intensive care medicine · 2026Review
- Epigenetic Aging of Critical Illness Survivors Assessed by the Muscle-Specific "Clock" and Its Relationship With Reduced Long-Term Muscle Strength.Aging cell · 2026Article
- Fluid Shifts and Muscle Loss in Critical Care: Accuracy of Ultrasound Versus Bioelectrical Impedance Analysis.Nutrients · 2026Observational
- The Feasibility, Safety, and Preliminary Functional Outcomes of a Mobile Application-Based Rehabilitation Program in Non-Ambulatory Patients After Intensive Care Unit Discharge.Journal of clinical medicine · 2026Article
- Early Measurement of Quadriceps Response to Neuromuscular Electrical Stimulation to Identify Future ICU-Acquired Weakness.Critical care medicine · 2026Observational
- Intensive Care Unit Acquired Weakness as a Modifiable Organ Dysfunction? A Narrative Review of Evolving Diagnostic and Therapeutic Concepts.Nutrients · 2026Review
- The impact of lipid-rich nutrition on ketogenesis and muscle weakness in sepsis.Intensive care medicine experimental · 2026Article
- Early mobilization to prevent ICU-acquired weakness in mechanically ventilated patients: an integrative review.Frontiers in medicine · 2026Review
- Development and Validation of a Prediction Model for Intensive Care Unit-Acquired Weakness in Adult Patients with Sepsis: A Prospective, Observational, Single-Center Study.International journal of general medicine · 2026Article
40 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
11 authors at 1 institution in 1 country.
Funding
Abstract
purposeTo assess the independent association between ICU-acquired neuromuscular complications and 5-year mortality and morbidity. To explore the optimal threshold of the Medical Research Council (MRC) sum score, assessing weakness, for the prediction of 5-year outcomes.
methodsSub-analyses of a prospective, 5-year follow-up study including 883 EPaNIC patients (Early versus Late Parenteral Nutrition in Intensive Care) (Clinicaltrials.gov:NCT00512122), systematically screened in ICU for neuromuscular complications with MRC sum score ('MRC-cohort', N = 600), electrophysiology on day 8 ± 1 to quantify compound muscle action potential ('CMAP-cohort', N = 689), or both ('MRC&CMAP-cohort', N = 415). Associations between ICU-acquired neuromuscular complications and 5-year mortality, hand-grip strength (HGF, %predicted), 6-min-walk distance (6-MWD, %predicted) and physical function of the SF-36 quality-of-life questionnaire (PF-SF-36) at 5-years were assessed with Cox regression and linear regression, adjusted for confounders. The optimal threshold for MRC at ICU discharge to predict 5-year outcomes was determined by martingale residual plots (survival) and scatterplots (morbidity).
resultsBoth lower MRC sum score at ICU discharge, indicating less strength [HR, per-point-increase: 0.946 (95% CI 0.928-0.968), p = 0.001], and abnormal CMAP, indicating nerve/muscle dysfunction [HR: 1.568 (95% CI 1.165-2.186), p = 0.004], independently associated with increased 5-year mortality. In the MRC&CMAP-cohort, MRC [HR: 0.956 (95% CI 0.934-0.980), p = 0.001] but not CMAP [HR: 1.478 (95% CI 0.875-2.838), p = 0.088] independently associated with 5-year mortality. Among 205 survivors, low MRC independently associated with low HGF [0.866 (95% CI 0.237-1.527), p = 0.004], low 6-MWD [105.1 (95% CI 12.1-212.9), p = 0.043] and low PF-SF-36 [- 0.119 (95% CI - 0.186 to - 0.057), p = 0.002], whereas abnormal CMAP did not correlate with these morbidity endpoints. Exploratory analyses suggested that MRC ≤ 55 best predicted poor long-term morbidity and mortality. Both MRC ≤ 55 and abnormal CMAP independently associated with 5-year mortality.
conclusionsICU-acquired neuromuscular complications may impact 5-year morbidity and mortality. MRC sum score, even if slightly reduced, may affect long-term mortality, strength, functional capacity and physical function, whereas abnormal CMAP only related to long-term mortality.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.