Abstract Details

Title Critical Illness Neuromyopathy: Risk Factors, Compound Muscle Action Potentials, and Outcome

Topic Critical Care/Emergency Neurology/Trauma

Presentation(s) P03 - (-)

Poster/Presentation
Number 146

Objective

Background BACKGROUND: Critical illness neuromyopathy (CINM) is a frequent complication of critical illness, resulting in increased morbidity and mortality. Prolongation of compound muscle action potential (CMAP) duration and numerous risk factors have been associated with the disorder.

Design/Methods DESIGN/METHODS: Patients diagnosed with CINM from 1994-2011 were identified. Clinical, laboratory, and electrodiagnostic findings were recorded. Traditional risk factors for CINM were identified. Outcome measures included post-hospital ambulatory status, modified Rankin Scale Score (mRS), and length of hospital stay.

Results RESULTS: 59 patients were identified with an average age of 58 (median = 60.5, range 21 - 91); 29 were females. Average number of risk factors present per patient was 7.8/10.8. Creatine kinase levels were mildly elevated in 8/52 and creatinine values were low in the majority of patients. Of the traditionally recognized risk factors, hyperglycemia and liver failure were independently associated with a worse ambulatory status at discharge. Electrodiagnostic studies were performed in all patients, with evidence of myopathy only and 27 had evidence of both myopathy and peripheral neuropathy. The presence of peripheral neuropathy was not associated with worse clinical outcome. However, patients with a higher numbers of risk factors were associated with higher post-hospital mRS, worse ambulatory status, and longer hospital stay.

Conclusions CONCLUSIONS: This retrospective study of a large cohort of patients with critical illness suggests: 1) hyperglycemia and liver failure independently correlate with worse clinical outcomes; 2) CINM is associated with low creatinine levels; 3) the presence of multiple clinical risk factors correlate with electrodiagnostic findings and worse clinical outcomes.

Authors/Disclosures
Christopher L. Kramer, MD (Mayo Clinic) PRESENTER	Dr. Kramer has nothing to disclose.
Jorg Dietrich, MD, PhD, FAAN	Dr. Dietrich has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Novartis. Dr. Dietrich has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Ono Pharmaceuticals. Dr. Dietrich has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Johnson & Johnson. Dr. Dietrich has received publishing royalties from a publication relating to health care.
Andrea Boon, MD (Mayo Clinic)	Dr. Boon has received personal compensation in the range of $500-$4,999 for serving as a Consultant for HPE cosmetics .
C. M. Harper, MD, FAAN (Mayo Clinic)	Dr. Harper has nothing to disclose.
Brent P. Goodman, MD (Dept of Neuro /Mayo Clinic)	Dr. Goodman has nothing to disclose.

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