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Published on: April 12, 2011
Long-term outcome in patients with critical illness myopathy or neuropathy: the Italian multicentre CRIMYNE study
B Guarneri1, G Bertolini, N Latronico
1Department of Neuroscience, Section of Clinical Neurophysiology, University of Brescia, Spedali Civili, Italy.
Insights
Critical illness myopathy (CIM) and polyneuropathy (CIP) affect intensive care unit (ICU) patients. Differentiating CIM from CIP is crucial, as CIM shows a better long-term prognosis than CIP.
Area of Science:
- Critical care medicine
- Neurology
- Intensive care unit (ICU) patient outcomes
Background:
- Critical illness myopathy (CIM) and polyneuropathy (CIP) are common in ICU patients.
- Combined CIP/CIM also occurs frequently.
- Current evidence does not support differentiating CIP from CIM for prognostic impact.
Purpose of the Study:
- To investigate the long-term outcomes of patients with CIM and CIP.
- To determine if differential diagnosis impacts patient prognosis.
Main Methods:
- A 1-year prospective cohort study was conducted.
- Patients developing CIP, CIM, or combined CIP/CIM during ICU stay were included.
- Electrophysiological signs were monitored.
Main Results:
- 30.4% of patients showed electrophysiological signs of CIP and/or CIM.
- At hospital discharge, diagnoses varied among survivors (CIM, CIP, combined CIP/CIM).
- CIM patients demonstrated better recovery rates (5/6) compared to CIP (1/4) and CIP/CIM (1/3) over 1 year.
Conclusions:
- Critical illness myopathy (CIM) has a more favorable prognosis than critical illness polyneuropathy (CIP).
- Differential diagnosis between CIM and CIP is essential for predicting long-term outcomes in ICU survivors.
- This distinction aids in personalized patient management and prognosis.
Background:
Critical illness myopathy (CIM) and polyneuropathy (CIP), alone or in combination (CIP/CIM), are frequent complications in patients in the intensive care unit (ICU). There is no evidence that differentiating between CIP and CIM has any impact on patient prognosis.
Methods:
1-year prospective cohort study of patients developing CIP, CIM or combined CIP and CIM during ICU stay.
Results:
28 out of 92 (30.4%) patients developed electrophysiological signs of CIP and/or CIM during their ICU stay, which persisted in 18 patients at ICU discharge. At hospital discharge, diagnoses in the 15 survivors were CIM in six cases, CIP in four, combined CIP and CIM in three and undetermined in two uncooperative patients. During the 1-year follow-up of six patients with CIM, one patient died and five recovered completely within 3 (three patients) to 6 (two patients) months. Of three patients with CIP/CIM, one died, one recovered and one with residual CIP remained tetraplegic. Of four patients with CIP, one recovered, two had persisting muscle weakness and one remained tetraparetic.
Conclusion:
CIM has a better prognosis than CIP. Differential diagnosis is important to predict long-term outcome in ICU patients.
