Muscle weakness assessment in older intensive care unit patients

Abstract

INTRODUCTION: After long periods of hospitalization, older adults may develop muscle weakness that can affect their functional independence after discharge. OBJECTIVE: To assess muscle weakness in older patients admitted to an ICU. METHOD: This cross-sectional, descriptive study with a quantitative approach assessed functional independence with the Katz Index and post-ICU muscle strength with a handgrip strength (HS) test and the Medical Research Council (MRC) sum-score. The sample consisted of 60 patients with an average age of 76 (60–99) years, 36 (60%) of whom were female. RESULTS: Post-ICU, 86.7% of the patients were functionally dependent. Female patients had significantly lower HS than males: 7 (0–24) vs. 17 (1–37) (p < 0.001). Female patients who received mechanical ventilation (MV) or sedation had significantly lower HS and MRC scores than those who did not (p < 0.001): HS MV 1 (0–13) vs. 11 (0–24) p < 0.001; MRC MV 35 (14–48) vs. 43 (27–57) p < 0.001; HS sedation 0 (0–12) vs. 9 (0–24) p < 0.001; MRC sedation 34 (14–36) vs. 42 (22–57) p < 0.001, respectively. Finally, there was an inversely proportional correlation between HS, MRC scores, and ICU length of stay, Spearman’s rho = -0.267 (p = 0.0039) and Spearman’s rho = -0.347 (p = 0.007), respectively. CONCLUSION: Older women who received mechanical ventilation and sedation have lower muscle strength than those who did not. As the ICU length of stay increases, muscle strength decreases.

Sarcopenia, falls and mistreatment in the context of fragile Elderly Syndrome: A bibliographic literature review

“…Thus, hospitalized elderly people are often the ones who develop more severe sarcopenia (DÍAZ et al, 2020). Patients in intensive care units tend to have muscle weakness and there was a worsening of the reduction in muscle mass in those who required mechanical ventilation and sedation, this clinical condition being more observed in women (LOPES et al, 2020). Tamura et al (2018), in a study with 323 elderly people, found that sarcopenia stabilizes after the age of 80.…”

Sarcopenia, queda e maus-tratos no contexto da síndrome do idoso frágil: uma revisão bibliográfica de literatura

“…Desta forma, idosos hospitalizados com frequência são os que avançam com um quadro de sarcopenia mais grave (DÍAZ et al, 2020). Pacientes de unidades de terapia intensiva tendem a ficar com fraqueza muscular e se verificou piora na redução da massa muscular naqueles que necessitaram de ventilação mecânica e sedação, sendo essa condição clínica mais observada em mulheres (LOPES et al, 2020). Tamura et al (2018), em estudo com 323 idosos, verificou que a sarcopenia estabiliza-se a partir dos 80 anos.…”