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

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.