Epidemiology of patients admitted in awareness recovery units in the nord pas de calais region (france)
Dr Franck BEAUCAMPa, Dr Sophie FOLLETb, Dr Xavier MOLDERSc, Dr Nathalie DUBRUNFAUTd, Dr Caroline ROGEAUc, Dr Bernard RIEGELc, Dr Odile KOZLOWSKIe, Dr Marc ROUSSEAUXc, Dr Etienne ALLARTc
a CH roubaix (centre de rééducation guy talpaert), b fondation hopale berck, c CHRU Lille, d fondation hopale fouquiéres-les-lens, e reseau TC/AVC 59-62
Objectives: The main objective of this study was to describe the population of patients hospitalized in awareness recovery units[AE1] , since the occurrence of brain-injury until their discharge. Secondary objectives were to know which criteria could influence length of stay in awakening centers and to judge evolution of patients' autonomy.
Patients and methods: Multicenter prospective longitudinal study about inpatients hospitalized in 2013 and 2014 in the 4 awareness recovery units (ARU) of the Nord pas de Calais region. Analyzed data were related to socio-demographic characteristics of patients, brain injury characteristics, characteristics of the stay in intensive care and ARU (including functional evolution) and study of the destination of discharged patients.
Results: 182 patients were included (117 male, 64.2%; 46±14 yo) divided as such: CHU Lille (37.4%), Hopale Berck (29.7%) Hopale Fouquières-lès-Lens (19.2%) CH Roubaix (13.7%). Patients suffered from traumatic brain injury (53.6%), ruptured aneurysm (22.1%), stroke (13.8%) and cerebral anoxia (6,1%), the distribution was homogeneous by center. Socio-demographic data of patients by pathology was similar to the literature data. The median coma duration was 29 days; time to admission in ARU was 57days, it was independent of the nature of pathology. The median length of stay in ARU was 65 days, but with substantial variability (mean 108 days). Time to admission since brain-injury was positively correlated to the length of stay in ARU. Autonomy of patients (physical, communication, GOS) was significantly improved between the beginning and the end of the stay in ARU. Conventionnal neurorehabilitation PMR units were the main destination of discharged patients.
Discussion: This exhaustive study of all ARU of the Nord pas de Calais region draws a global panorama of patients during their stay in intensive care upon discharge. It can serve as an initial reflexion to improve actual practices, and put the light on the necessity of leading other longitudinal works of the articulation between acute and rehabilitation care.
Keywords : coma, awarness, epidemiology