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Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: Manual muscle strength testing of critically ill patients: feasibility and interobserver agreement. | Hough et al. Critical Care 2011 15 R43 http ccforum.eom content 15 1 R43 KS CRITICAL CARE RESEARCH Open Access Manual muscle strength testing of critically ill patients feasibility and interobserver agreement Catherine L Hough Binh K Lieu Ellen S Caldwell Abstract Introduction It has been proposed that intensive care unit ICU -acquired weakness ICUAW should be assessed using the sum of manual muscle strength test scores in 12 muscle groups the sum score . This approach has been tested in patients with Guillain-Barré syndrome yet little is known about the feasibility or test characteristics in other critically ill patients. We studied the feasibility and interobserver agreement of this sum score in a mixed cohort of critically ill and injured patients. Methods We enrolled patients requiring more than 3 days of mechanical ventilation. Two observers performed systematic strength assessments of each patient. The primary outcome measure was interobserver agreement of weakness as a binary outcome ICUAW is sum score less than 48 no ICUAW is a sum score greater than or equal to 48 using the Cohen s kappa statistic. Results We identified 135 patients who met the inclusion criteria. Most were precluded from study participation by altered mental status or polytrauma. Thirty-four participants were enrolled and 30 of these individuals completed assessments conducted by both observers. Six met the criteria for ICUAW recorded by at least one observer. The observers agreed on the diagnosis of ICUAW for 93 of participants Cohen s kappa 0.76 95 confidence interval CI 0.44 to 1.0 . Observer agreement was fair in the ICU Cohen s kappa 0.38 and agreement was perfect after ICU discharge Cohen s kappa 1.0 . Absolute values of sum scores were similar between observers intraclass correlation coefficient 0.83 95 CI 0.67 to 0.91 but they differed between observers by six points or more for 23 of the participants. Conclusions Manual muscle testing MMT during critical illness was not possible
