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Study Aims

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  1. EPIDEMIOLOGY AND EARLY DIAGNOSIS OF HETEROTOPIC OSSIFICATION IN CRITICAL ILL PATIENTS. PRELIMINARY DATA A. Christakou, M. Alimatiri, I. Patsaki, A. Kouvarakos, E. Papadopoulos, K. Stefanidis, D. Karakitsos,C.S.Vrettou, V. Markaki, S. Nanas N a t i o n a l a n d K a p o d i s t r i a n U n i v e r s i t y, M e d i c a l S c h o o l , F i r s t C r i t i c a l C a r e D e p a r t m e n t , E v a n g e l i s m o s H o s p i t a l , A t h e n s , G r e e c e Study Aims Methods Results Conclusion Please navigate using mouse/arrows or use buttons to jump to a specific slide

  2. Background and Study Aims • Acquired neurogenicheterotopic ossification (NHO) is a well-recognized condition in intensive care unit (ICU) (Genet et al., 2011; Simonsen et al., 2007) • It effects patients' mobility and morbidity, time of hospitalization and cost (Van Campen et al., 2011) • The purpose of this study was to assess the role of joint mobility, pain and ultrasonography in early diagnosis in critical ill patients in a general ICU Results Conclusion Methods

  3. Methods 1.: Flow chart 85 consecutive patients discharged from the ICU Inclusion criteria: - mechanical ventilation > 72h - age 18-75 years - length of stay in ICU at least 5 days - not previous HO 45 patients were excluded & 25 patients were deceased 20 patients were eligible for the study

  4. Methods 2.: Baseline characteristics (mean ± SD) • 20 patients were evaluated (M:14,F:6) (age 51±16 years) • ICU stay (days)20.0±13.6 • Mechanical ventilation (days) 13.4 ±10.1 • Apache II admission score 15.7±6.2 • Sofa admission score 6.9±2.1 • GCS 9.1 ± 4.1

  5. Methods 3.: Assessment tools • The patients received weekly assessment of passive range of motion (pROM) of hip, knee, shoulder and elbow joints with a goniometry • The pain during joint mobilization was evaluated by Behavioral Pain Scale (BPS) (Payen et al., 2009) & numeric Visual Analogue Scale (VAS) • An ultrasonography was performed in any clinically suspected patient • Confirmation of NHO diagnosis by ultrasonography & radiography Go to Go to Results Conclusion

  6. Assessment of HO with goniometry Back

  7. Confirmation of HO with X-Ray Back

  8. Results 1.: Incidence of NHO • The incidence of NHO was 2 out of 20 cases (10%) with acquired brain injury • NHO was located in the hip joint in one case and in the hip and elbow joints in the second case • The mean time of NHO diagnosis following their admission day in ICU was 10 ± 4 weeks

  9. Go to [Fig.1& 2]. [Fig.3& 4]. (mean ± SD) Conclusion (mean ± SD)

  10. Figure 1 & 2. Histograms of % pROM hip and elbow joints Back

  11. Figure 3 & 4. Histograms of % pain of hip and shoulder joints Back

  12. Conclusions • Heterotopic ossification is a common complication in the ICU • Ultrasonography may play a pivotal diagnostic role in the identification and early detection of NHO • Limitation was the relatively small number of critically ill patients • Further studies are needed to determine a valid risk profile of a critical ill patient with HO for the administration of preventive measures Back to top