Medicosocial outcome after admission in post-intensive care unit at PRM St-Hélier, Rennes

• Published in: Annals of physical and rehabilitation medicine Vol. 58; p. e50
• Main Authors: Leblong-Lecharpentier, E, Autret, K., Dr, Duruflé, A., Dr, Le Meur, C., Dr, Petrilli, S., Dr, Robineau, S., Dr, Berthier, T., Dr, Nicolas, B., Dr, Gallien, P., Dr
• Format: Journal Article
• Language: English
• Published: Elsevier Masson SAS 01.09.2015
• Subjects: Brain injury; Internal Medicine; Participation; Physical Medicine and Rehabilitation; Post-intensive care; Social outcome; Participation; Post-intensive care; Social outcome; Brain injury
• ISSN: 1877-0657; 1877-0665
• DOI: 10.1016/j.rehab.2015.07.123

Introduction Post-Intensive Care Units (PICU) are PRM structures aiming to start the appropriated rehabilitative care as early as possible even though persistent complex medical issues. Objective To assess medicosocial outcomes of patients away from their admission in PICU. Methods A retrospective descriptive study that included 81 consecutive patients (mean age 51 years) admitted from 2008 to 2012 in the PICU of Pôle St-Helier Rennes based on called semi-structured interviews between March 2014 and March 2015. Exhaustive data (only 4 lost, 5%) by the patient himself and/or a member of family on autonomy, place of life, structures since the release and reintegration, of patients for 85% of them brain damaged. Results There is 29% (21/77) of death (post-exit life: 1,6 years ± 1.18). Eighty percent live at home (46/56) of which only 5 without family environment, 10% (5/56) in medicosocial structures (foster or nursing homes…), 10% in hospital (hospital at home, persistent vegetative units…). Fourteen percent (8/56) are completely autonomous and work, all with adaptations. Twenty-three percent (13/56) had a significant dependence for activities of daily life and instrumental ones. Forty percent (22/56) have no hobby. Use of different downstream structures, long-term readaptative monitoring, legal and families’ feelings were also analyzed. Discussion and Conclusion Medical and social outcome of patients in the aftermath of a stay in PICU is disparate, depending on the pathology involved, but also the pre-social situation that seems to be the main predictor of returning home. Most patients have regained a relatively large autonomy for the daily life activities but are embarrassed to complex instrumental activities impeding social inclusion. These results are consistent with those of the literature on head trauma patients but no other study has focused for the moment on the specific population of patients admitted to the PICU. We see the value of such early rehabilitative care units with a real impact on the subsequent independence and opportunities back home.