Editorial Open Access
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jun 26, 2024; 12(18): 3288-3290
Published online Jun 26, 2024. doi: 10.12998/wjcc.v12.i18.3288
Unveiling significant risk factors for intensive care unit-acquired weakness: Advancing preventive care
Chun-Yao Cheng, Department of Medical Education, National Taiwan University Hospital, Taipei 100225, Taiwan
Wen-Rui Hao, Division of Cardiology, Department of Internal Medicine, Shuang Ho Hospital, Ministry of Health and Welfare, Taipei Medical University, New Taipei 23561, Taiwan
Wen-Rui Hao, Division of Cardiology, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei 11002, Taiwan
Tzu-Hurng Cheng, Department of Biochemistry, School of Medicine, College of Medicine, China Medical University, Taichung 404333, Taiwan
ORCID number: Tzu-Hurng Cheng (0000-0002-9155-4169).
Co-first authors: Chun-Yao Cheng and Wen-Rui Hao.
Author contributions: Cheng CY wrote the paper; Hao WR and Cheng TH revised the paper. All authors have read and approved the final manuscript. Cheng CY and Hao WR contributed equally to this work as co-first authors.
Supported by China Medical University, No. CMU111-MF-102.
Conflict-of-interest statement: The authors declare having no conflicts of interest.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Tzu-Hurng Cheng, PhD, Professor, Department of Biochemistry, School of Medicine, College of Medicine, China Medical University, No. 91 Xueshi Road, North District, Taichung 404333, Taiwan. thcheng@mail.cmu.edu.tw
Received: February 24, 2024
Revised: April 23, 2024
Accepted: April 25, 2024
Published online: June 26, 2024
Processing time: 114 Days and 22.3 Hours


In this editorial, we discuss an article titled, “Significant risk factors for intensive care unit-acquired weakness: A processing strategy based on repeated machine learning,” published in a recent issue of the World Journal of Clinical Cases. Intensive care unit-acquired weakness (ICU-AW) is a debilitating condition that affects critically ill patients, with significant implications for patient outcomes and their quality of life. This study explored the use of artificial intelligence and machine learning techniques to predict ICU-AW occurrence and identify key risk factors. Data from a cohort of 1063 adult intensive care unit (ICU) patients were analyzed, with a particular emphasis on variables such as duration of ICU stay, duration of mechanical ventilation, doses of sedatives and vasopressors, and underlying comorbidities. A multilayer perceptron neural network model was developed, which exhibited a remarkable impressive prediction accuracy of 86.2% on the training set and 85.5% on the test set. The study highlights the importance of early prediction and intervention in mitigating ICU-AW risk and improving patient outcomes.

Key Words: Intensive care unit-acquired weakness, Artificial intelligence, Machine learning, Neural network, Risk factors, Prediction, Critical care

Core Tip: This editorial comment on the published article related to the potential of artificial intelligence (AI) and machine learning in predicting and mitigating intensive care unit-acquired weakness (ICU-AW) in critically ill patients. By identifying key risk factors and developing a predictive model, clinicians can optimize patient care and improve outcomes. Early prediction and intervention based on AI-driven insights may lead to more personalized and effective strategies for preventing ICU-AW.


Intensive care unit-acquired weakness (ICU-AW) presents a significant challenge in critical care medicine, impacting patient recovery and outcomes[1,2]. Wang and Long's study, published in the World Journal of Clinical Cases, offers a meticulous investigation into the risk factors contributing to ICU-AW and proposes an innovative approach to its prevention and treatment[3]. Using advanced iterative machine learning techniques, Wang and Long[3] conducted a comprehensive analysis of data from intensive care unit (ICU) patients, identifying key risk factors associated with the development of ICU-AW. Their study, conducted at the People's Hospital of Qiandongnan Miao and Dong Autonomous Prefecture, China, provides critical insights into this debilitating condition. The research team found that the length of ICU stay and the duration of mechanical ventilation emerged as the most significant predictors of ICU-AW. Patients with prolonged stays in the ICU and extended periods of mechanical ventilation were at heightened risk of developing this condition. Additionally, factors such as age, sedative dosage, vasopressor dosage, and specific comorbidities were also implicated, underscoring the multifaceted nature of ICU-AW. One of the highlights of the study is the development of a multilayer perceptron neural network model with remarkable predictive performance. With an area under the curve of 0.941, sensitivity of 92.2%, and specificity of 82.7%, the model demonstrated exceptional accuracy in predicting ICU-AW. This sophisticated tool holds immense promise in clinical practice, enabling healthcare providers to proactively identify patients at risk and implement targeted interventions.

The findings of Wang and Long[3] underscore the intricate interplay of factors contributing to ICU-AW and emphasize the importance of preventive measures. By reducing both ICU length of stay and mechanical ventilation duration, health-care providers can mitigate the risk of ICU-AW and enhance patient outcomes. Furthermore, the study underscores the potential of machine learning in advancing critical care medicine, offering novel avenues for research and clinical application. However, as with any study, several caveats must be made. The authors acknowledge the study’s limitations, including a reliance on data from a single center, which may limit the generalizability of findings. Furthermore, despite the commendable performance exhibited by the neural network model, continual refinement and validation across various clinical settings is crucial to ensuring its robustness and practicality.


The research of Wang and Long[3] marks a milestone in critical care medicine, providing invaluable insights into the prevention and management of ICU-AW. By elucidating key risk factors and leveraging advanced machine learning techniques, their study lays the foundation for tailored patient care approaches and underscores the vital role of interdisciplinary collaboration in improving outcomes for critically ill patients. As the medical community navigates the complexities of critical illness, studies like theirs illuminate the way forward, providing more efficient and patient-centered care practices.


Provenance and peer review: Invited article; Externally peer reviewed.

Peer-review model: Single blind

Specialty type: Medicine, research and experimental

Country of origin: Taiwan

Peer-review report’s classification

Scientific Quality: Grade B

Novelty: Grade B

Creativity or Innovation: Grade B

Scientific Significance: Grade B

P-Reviewer: Covino M, Italy S-Editor: Qu XL L-Editor: A P-Editor: Yu HG

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