Shoulder dysfunction in intensive care survivors:an investigation into prevalence, risk factors and impact on upper limb function

Abstract

Background: Limitations in function and quality of life have been reported in intensive care unit survivors for many years after hospital discharge. Shoulder dysfunction is a cause of functional limitation in other patient populations, and has been suggested as a potential cause in intensive care unit survivors. Despite this, the prevalence of shoulder dysfunction, its impact on upper limb function and risk factors for its development are unknown in intensive care unit survivors. Methods: A cohort study of intensive care unit survivors from a single general intensive care unit was undertaken using prospective and retrospective data. Participants underwent a series of shoulder assessments up to 6 months after hospital discharge to identify shoulder dysfunction and upper limb impairment. Multivariable analysis was used to investigate the risk factors for developing shoulder dysfunction. Results: Shoulder dysfunction was present in 76% of participants, with 42% presenting with ongoing shoulder dysfunction at 6 months after hospital discharge. Functional impairment of the upper limb was present in 48% of participants and severe impairment in 18%. None of the risk factors analysed were independently associated with shoulder dysfunction. Conclusions: Shoulder dysfunction is a common problem in intensive care unit survivors, and is a source of functional impairment. Further investigation addressing risk factors for its development, and therapeutic interventions to address this problem is required

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