ArticleJournal of inflammation research2026
Risk Factors and Prediction Model for ICU-Acquired Weakness in Severe Acute Pancreatitis: A Retrospective Cohort Study.
Article in Journal of inflammation research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Objective: To investigate the incidence and independent risk factors of intensive care unit-acquired weakness (ICU-AW) in patients with severe acute pancreatitis (SAP) and to develop and validate a corresponding risk prediction model. Methods: In this retrospective study, 277 SAP patients admitted to the ICU between January 2020 and March 2024 were enrolled. ICU-AW was diagnosed using the Medical Research Council sum score (MRC-SS), with a score <48 defining the condition. Patients were randomly split into a modeling cohort (70%) for model development and a validation cohort (30%) for internal validation. Univariate and multivariate logistic regression analyses were employed to identify factors associated with ICU-AW. A nomogram was constructed based on independent predictors identified from the multivariate analysis. The model's performance was assessed by the area under the receiver operating characteristic curve (AUC) and the Hosmer-Lemeshow (H-L) test. Results: The incidence of ICU-AW was 38.6% (107/277) among the enrolled SAP patients. Multivariate analysis identified age ≥51 years (OR=5.83), APACHE II score ≥14 (OR=11.19), ICU length of stay ≥7 days (OR=12.61), use of neuromuscular blocking agents (OR=3.34), D-lactate ≥41.69 mg/L (OR=2.92), and presence of nutritional risk (OR=5.34) as independent risk factors for ICU-AW. Early rehabilitation care was a significant protective factor (OR=0.18). The prediction nomogram incorporating these seven factors demonstrated excellent discrimination, with an AUC of 0.922 (95% CI: 0.884-0.959) in the modeling cohort and 0.918 (95% CI: 0.873-0.963) in the validation cohort. The H-L test indicated good calibration in both cohorts (P=0.903 and P=1.000, respectively). Conclusion: ICU-AW is a common complication in SAP patients. We developed a nomogram that effectively integrates readily available clinical variables (age, disease severity, ICU stay, medication use, D-lactate, nutritional status, and rehabilitation care) to individually predict the risk of ICU-AW. This model may assist clinicians in early identification of high-risk patients and facilitate targeted preventive strategies.
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