Risk factors for acquired weakness in intensive care unit patients: An umbrella review.

Yimei Zhang, Qiulan Hu, Min Zhou, Yu Wang, Jingran Yang, Xiaorong Jin, Xiong Zhang, Fang Ma
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Abstract

Objective: This umbrella review aims to summarize and synthesize the evidence on risk factors related to intensive care unit-acquired weakness in systematic reviews to create prevention strategies and intervention measures for intensive care unit-acquired weakness.

Methodology: Eight databases were searched systematically from inception to 1st November 2023. Two researchers independently screened and extracted data based on predefined inclusion and exclusion criteria. The methodological quality, risk of bias and certainty of evidence of reviews included were evaluated using version 2 of the Measurement Tool for Evaluation System Review (AMSTAR-2) and the Risk of Bias in Systematic Reviews (ROBIS), and the Grading of Recommendations Assessment, Development and Evaluation(GRADE) respectively.

Results: This review included 10 systematic reviews, reporting a total of 42 factors and 22 associations with meta-analysis. Overall, among these associations, the methodological and evidence quality of the majority ofstudies was rated as low or extremely low. Most systematic reviews and/or meta-analyses exhibited a high risk of bias.

Conclusion: This umbrella review comprehensively summarized the risk factors related to intensive care unit-acquired weakness and evaluated the methodological quality, risk of bias, and evidence quality of reviews included. Future studies with high-quality research such as cohort studies are needed, to better update and synthesize the risk factors of intensive care unit-acquired weakness.

Implications for clinical practice: Inconsistent or even contradictory findings exist among multiple systematic reviews regarding intensive care unit-acquired weakness. The present study offers a comprehensive and readily comprehensible overview of the risk factors linked to intensive care unit-acquired weakness, which is conducive to develop assessment tools for the condition and identify intervention targets.

重症监护病房患者后天性虚弱的危险因素:综述。
目的:本综述旨在总结和综合系统综述中重症监护病房获得性乏力相关危险因素的证据,以制定重症监护病房获得性乏力的预防策略和干预措施。方法:系统检索8个数据库,从成立到2023年11月1日。两名研究人员根据预定义的纳入和排除标准独立筛选和提取数据。采用第2版评价系统评价测量工具(AMSTAR-2)、系统评价偏倚风险(ROBIS)和建议评估、发展和评价分级(GRADE)分别对纳入评价的方法学质量、偏倚风险和证据确定性进行评价。结果:本综述包括10个系统综述,共报告42个因素和22个meta分析相关性。总的来说,在这些关联中,大多数研究的方法学和证据质量被评为低或极低。大多数系统评价和/或荟萃分析显示出较高的偏倚风险。结论:本综述全面总结了与重症监护病房获得性弱点相关的危险因素,并对纳入的综述的方法学质量、偏倚风险和证据质量进行了评价。未来需要进行高质量的研究,如队列研究,以更好地更新和综合重症监护病房获得性弱点的危险因素。对临床实践的启示:在关于重症监护病房获得性虚弱的多个系统综述中存在不一致甚至相互矛盾的发现。本研究提供了与重症监护病房获得性虚弱相关的风险因素的全面和易于理解的概述,这有助于开发病情评估工具和确定干预目标。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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