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重症监护病房幸存者的肌肉骨骼健康状况和身体功能:一项英国多中心前瞻性队列研究(MSK-ICU 研究)方案。

Musculoskeletal health state and physical function of intensive care unit survivors: protocol for a UK multicentre prospective cohort study (the MSK-ICU study).

机构信息

Centre for Movement, Occupational and Rehabilitation Sciences (MOReS), Oxford Institute of Nursing, Midwifery and Allied Health Research (OxINMAHR), Faculty of Health and Life Sciences, Oxford Brookes University, Oxford, UK

Oxford Allied Health Professions Research & Innovation Unit, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.

出版信息

BMJ Open. 2023 Feb 2;13(2):e071385. doi: 10.1136/bmjopen-2022-071385.

Abstract

INTRODUCTION

Survivors of critical illness frequently experience long-term physical impairment, decreased health-related quality of life and low rates of return to employment. There has been limited investigation of the underlying problems affecting physical function post-intensive care unit (ICU) admission. Musculoskeletal (MSK) conditions may be complex in presentation, with ICU survivors potentially at greater risk of their development due to the rapid muscle mass loss seen in ICU. The MSK health state of ICU survivors and its impact on physical function remain largely unknown. The aim of the MSK-ICU study is to determine and characterise the MSK health state of ICU survivors 6 months following admission to ICU, in order to inform development of targeted rehabilitation interventions.

METHODS AND ANALYSIS

The MSK-ICU study is a multicentre prospective longitudinal cohort study, evaluating the MSK health state of ICU survivors 6 months after admission to ICU. The study consists of a primary study and two substudies. The primary study will be a telephone follow-up of adults admitted to ICU for more than 48 hours, collecting data on MSK health state, quality of life, employment, anxiety and depression and symptoms of post-traumatic stress disorder. The planned sample size is 334 participants. Multivariable regression will be used to identify prognostic factors for a worse MSK health state, as measured by the MSK-Health Questionnaire. In substudy 1, participants who self-report any MSK problem will undergo a detailed, in-person MSK physical assessment of pain, peripheral joint range of movement and strength. In substudy 2, participants reporting a severe MSK problem will undergo a detailed physical assessment of mobility, function and muscle architecture.

ETHICS AND DISSEMINATION

Ethical approval has been obtained through the North of Scotland Research Ethics Committee 2 (21/NS/0143). We aim to disseminate the findings through international conferences, international peer-reviewed journals and social media.

TRIAL REGISTRATION NUMBER

ISRCTN24998809.

摘要

简介

危重病幸存者常经历长期的身体功能障碍、生活质量下降和重返工作岗位的比例较低。对影响重症监护病房(ICU)后身体功能的潜在问题的研究有限。肌肉骨骼(MSK)疾病的表现可能较为复杂,由于 ICU 中可见的肌肉质量迅速丧失,ICU 幸存者的发病风险可能更高。 ICU 幸存者的 MSK 健康状况及其对身体功能的影响在很大程度上仍不清楚。MSK-ICU 研究旨在确定和描述 ICU 幸存者在入住 ICU 6 个月后的 MSK 健康状况,以便为针对性康复干预措施的制定提供信息。

方法和分析

MSK-ICU 研究是一项多中心前瞻性纵向队列研究,评估 ICU 幸存者在入住 ICU 6 个月后的 MSK 健康状况。该研究包括一项主要研究和两项子研究。主要研究将是对入住 ICU 超过 48 小时的成年人进行电话随访,收集有关 MSK 健康状况、生活质量、就业、焦虑和抑郁以及创伤后应激障碍症状的数据。计划的样本量为 334 名参与者。多变量回归将用于确定 MSK 健康状况较差的预测因素,该指标通过 MSK-Health 问卷进行测量。在子研究 1 中,自我报告有任何 MSK 问题的参与者将接受详细的 MSK 身体评估,包括疼痛、外周关节活动度和力量。在子研究 2 中,报告有严重 MSK 问题的参与者将接受详细的身体评估,包括移动性、功能和肌肉结构。

伦理和传播

已通过苏格兰北部研究伦理委员会 2 号(21/NS/0143)获得伦理批准。我们旨在通过国际会议、国际同行评议期刊和社交媒体传播研究结果。

试验注册编号

ISRCTN24998809。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3856/9896246/7a3d449dd382/bmjopen-2022-071385f01.jpg

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