重症监护病房获得性衰弱危险因素的Meta分析

Intensive care unit-acquired weakness:a meta-analysis of risk factors

目的通过Meta分析明确重症监护病房获得性衰弱(intensive care unit-acquired weakness,ICU-AW)的危险因素。方法检索中国知网(CNKI)、万方数据库、维普中文科技期刊数据库、中国生物医学文献数据库(CBM)、PubMed、Embase、MedLine、Web of Science、the Cochrane Library从建库至2022年10月有关ICU获得性衰弱危险因素的病例对照研究和队列研究。2名研究人员按照标准独立筛选文献、提取资料、评价文献质量。采用RevMan 5.4软件对资料进行Meta分析。结果共纳入9篇文献,包括3项病例对照研究和6项队列研究,总样本量为1460例。Meta分析结果显示,年龄[MD=5.47,95%CI(2.71,8.24)]、女性[OR=3.33,95%CI(1.85,5.98)]、高血糖[OR=2.96,95%CI(1.70,5.13)]、APACHEⅡ评分[MD=4.39,95%CI(3.17,5.60)]、脓毒症[OR=6.22,95%CI(2.95,13.10)]、多器官功能障碍综合征[OR=6.54,95%CI(4.90,8.18)]、高乳酸血症[MD=1.81,95%CI(1.43,2.20)]、使用氨基糖苷类药物[OR=2.74,95%CI(1.76,4.27)]、机械通气[MD=4.27,95%CI(3.42,5.12)]是ICU-AW的危险因素。结论年龄、女性、高血糖、APACHEⅡ评分、脓毒症、多器官功能障碍综合征、高乳酸血症、使用氨基糖苷类药物、机械通气为ICU-AW的独立危险因素。

Objective To identify the risk factors of intensive care unit(ICU)-acquired weakness(ICU-AW)by meta-analysis.Methods Computerized retrieval of PubMed,Embase,MedLine,Web of Science,the Cochrane Library,CNKI,CBM,WanFang Data and VIP databases was carried out.Case-control studies and cohort studies about risk factors of ICU-AW were collected from the database establishment to October 2022.Two researchers screened the literature according to the inclusion and exclusion criteria,and extracted data,assessed the quality of included studies independently.Meta-analysis was conducted by RevMan5.4.Results A total of 9 studies were included,including 3 case-control studies and 6 cohort studies,with a sample size of 1460 cases.The results of meta-analysis showed that age[MD=5.47,95%CI(2.71,8.24)],female[OR=3.33,95%CI(1.85,5.98)],hyperglycemia[OR=2.96,95%CI(1.70,5.13)],APACHEⅡscore[MD=4.39,95%CI(3.17,5.60)],sepsis[OR=6.22,95%CI(2.95,13.10)],multiple organ dysfunction syndrome(MODS)[OR=6.54,95%CI(4.90,8.18)],hyperlactatemia[MD=1.81,95%CI(1.43,2.20)],treatment with any aminoglycoside[OR=2.74,95%CI(1.76,4.27)],duration of mechanical ventilation[MD=4.27,95%CI(3.42,5.12)]were independent risk factors for ICU-AW.Conclusion Age,female,hyperglycemia,APACHEⅡscore,sepsis,MODS,hyperlactatemia,treatment with any aminoglycoside,and duration of mechanical ventilation were independent predictors for ICU-AW.