Changes in muscle strength, physical performance, and their associated factors in oncologic patients after critical...

The period of bed rest during intensive care unit (ICU) stay can lead to deleterious effects, such as muscle weakness and reduced mobility over an extended period.

The aim of this study was to analyse changes in handgrip strength (HGS) and physical performance, as well as their associated factors, in oncological patients following critical illness.

A prospective cohort study was conducted in patients with cancer discharged from the ICU of a tertiary oncology unit between March 2023 and March 2024. Patients with an ICU length of stay shorter than 3 days, cognitive impairment preventing understanding of commands and performance of tests, or refusal to participate were excluded from the study. HGS and the 30-s chair-stand test (CS-30) were used to assess muscle strength and physical performance at two time points: ICU discharge and hospital discharge. The association between continuous variables and outcomes was analysed using univariate and multivariate linear regression.

A total of 89 patients were included in the study. The majority were men (57.3%) who underwent surgery or surgery combined with chemotherapy for the treatment of malignant neoplasia (58.4%). The mean HGS at ICU discharge was 17.8 (±10.77), increasing to 20.9 (±10.07) at hospital discharge. Muscle strength assessed by the Medical Research Council-sum score at ICU discharge (β = 0.90; 95% confidence interval: [0.09-1.70]; p = 0.02) was independently associated with changes in HGS between ICU and hospital discharge. The mean CS-30 score at ICU discharge was 1.2 (±2.47) repetitions, increasing to 3.3 (±3.41) repetitions at hospital discharge. Sex (β = -1.43; 95% confidence interval: [-2.60 to -0.26]; p = 0.01) was independently associated with changes in CS-30 repetitions between ICU and hospital discharge.

Improvements in HGS and physical performance were observed in patients with cancer after critical illness. Muscle strength at ICU discharge and sex were independent predictors of changes in HGS and physical performance following ICU discharge.