ICU sedation, delirium & recovery
Early prediction of intensive care unit-acquired weakness using quadriceps ultrasound and routine clinical variables: development and temporal validation of a prospective multicentre machine-learning model
Authors' conclusion
This early ultrasound-clinical model may identify patients at high risk of ICUAW before strength testing becomes feasible
Study context
- Population
- Adults expected to remain in ICU ≥ 3 days, 16 tertiary ICUs in southwest China; quadriceps ultrasound and clinical assessment within 24 h of admissiondevelopment n = 858
- Exposure
- Unpressurised RF model vs Pressurised RF model vs General RF model
- Outcome
- Intensive care unit-acquired weakness (ICUAW), defined by first evaluable Medical Research Council (MRC) score during ICU stay
Methodological detailsprediction model development and temporal external validation, machine-learning
- Prediction model development and temporal external validation
- Machine-learning
Main finding
As reported in the abstract
ICUAW prediction, external validation
| Group | AUC | Sensitivity | Specificity |
|---|---|---|---|
| Unpressurised RF model | 0.810 (95% CI 0.765-0.855) | 0.983 (0.952-0.997) | 0.726 (0.651-0.792) |
| Pressurised RF model | 0.730 [0.676-0.783] | — not stated in the abstract | 0.506 [0.427-0.585] |
AUC
Unpressurised RF model0.810 (95% CI 0.765-0.855)
Pressurised RF model0.730 [0.676-0.783]
Sensitivity
Unpressurised RF model0.983 (0.952-0.997)
Pressurised RF model— not stated in the abstract
Specificity
Unpressurised RF model0.726 (0.651-0.792)
Pressurised RF model0.506 [0.427-0.585]
— not stated in the abstract
Observational data: associations, not effects.
Further findings
ICUAW incidence
| Outcome | Estimate |
|---|---|
| Incremental value vs General RF modelUnpressurised RF model vs General RF model | cf-NRI 0.490 (95% CI 0.277–0.698) |
| Incremental value vs General RF modelUnpressurised RF model vs General RF model | IDI 0.072 (95% CI 0.045–0.099) |
| Incremental value vs General RF modelPressurised RF model vs General RF model | cf-NRI 0.231 (95% CI 0.011–0.463) |
| Incremental value vs General RF modelPressurised RF model vs General RF model · less consistent IDI improvement | IDI 0.019 (95% CI - 0.002 to 0.040) |
Key predictors (SHAP)
- Quadriceps muscle thickness, Sequential Organ Failure Assessment (SOFA) score, albumin and inflammatory markers key contributors
Original publication
Early prediction of intensive care unit-acquired weakness using quadriceps ultrasound and routine clinical variables: development and temporal validation of a prospective multicentre machine-learning model. J Intensive Care. Published 26 July 2026. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →