Diagnostic and prognostic value of muscle echogenicity combined with plasma inflammatory factors for intensive care unit-acquired weakness

Abstract:

Objective To investigate the correlation between muscle echogenicity and plasma inflammatory factors in patients with intensive care unit-acquired weakness（ICUAW） and its diagnostic and prognostic value for ICUAW.Methods Patients hospitalized in the intensive care unit（ICU） in Chongging Emergency Medical Center were included. Their muscle echogenicity was measured using bedside ultrasonography on the 1st，3rd，and 7th day，and the global muscle echogenicity（GME） score was assessed. Serum interleukin-6（IL-6） and procalcitonin（PCT） levels were measured. Muscle strength was scored using the Medical Research Council Scale for Muscle Strength（MRC-ss）. The patients were divided into ICUAW group and non-ICUAW group according to the MRC-ss score on the 7th day after admission to the ICU. We compared GME，IL-6，and PCT between the two groups，and analyzed their correlations with one another. Receiver operating characteristic（ROC） curves were generated to analyze the diagnostic efficacy and prognostic value of the above parameters for ICUAW.Results The ICUAW group showed a significantly higher GME score on day 3 and a significantly higher IL-6 level and GME score on day 7 compared with the non-ICUAW group（P<0.05）. On day 7，there was a significant positive correlation between the GME score and IL-6 level（r=0.221） and a significant negative correlation between the GME score and MRC-ss score（r=-0.581）. The ROC curve analysis showed that the GME score on day 7 had diagnostic and predictive value for ICUAW，and the area under the ROC curve（AUC） was 0.838； the diagnostic AUC of the combination of GME score，IL-6，and PCT was 0.885（P<0.05）. The Barthel index（BI） score was significantly lower in the ICUAW group than in the non-ICUAW group，and in the ICUAW group，patients with a higher GME score had a significantly lower BI than those with a lower GME score（P<0.05）.Conclusion The GME score is related to plasma IL-6 and PCT levels in ICU patients，showing value for the diagnosis and outcome prediction of ICUAW.