Medicosocial outcome after admission in post-intensive care unit at PRM St Hélier, Rennes
Mrs Emilie LEBLONG-LECHARPENTIERa, Dr Katell AUTRETa, Dr Aurélie DURUFLÉa, Dr Claire LE MEURa, Dr Sabine PETRILLIa, Dr Sandrine ROBINEAUa, Dr Typhaine BERTHIERa, Dr Benoit NICOLASa, Dr Philippe GALLIENa
a Pôle MPR St Hélier, Rennes
Introduction: Post-Intensive Care Units (PICU) are PRM structures aiming to start the appropriated rehabilitative care as early as possible even though persistant 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 Pole St Helier Rennes based on called semi-structured interviews between March 2014 and March 2015. Exhaustive datas (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). 80% 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 mome, persistent vegetative units...). 14% (8/56) are completely autonomous and work, all with adaptations. 23% (13/56) had a significant dependence for activities of daily life and instrumental ones. 40% (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.
Keywords : social outcome, post-intensive care, participation, brain injury