Defining needs and goals of post-ICU care for trauma patients: preliminary study

Minerva Anestesiol. 2016 Jan;82(1):22-9. Epub 2015 Apr 15.

Abstract

Background: The aim of this study was to assess the long-term physical and psychological disabilities and their economic impact in severe trauma survivors.

Methods: Adult patients with Injury Severity Score >15 and Abbreviated Injury Scale ≤3 admitted to the ICU of a Level 1 trauma centre in the Lazio Region and discharged alive from hospital underwent a structured interview 12-24 months after the event. Self-reported somatic symptoms, autonomy, anxiety and depression were evaluated using a Likert-type Scale, Barthel Index and Hospital Anxiety and Depression Score (HADS), respectively. Patients' working and economic status were also investigated.

Results: A total of 32/58 patients matching the inclusion criteria were included in the final analysis. Eighteen patients (56%) reported at least a partial restriction in daily activities. Most common symptoms included muscle or joint pain, fatigue, and headache. All patients were receiving rehabilitation 1-2 years after the event. Fifty-eight percent of the patients spent more than €3600/year from their family budget for rehabilitation and medical care, however only 25% were receiving financial support from regional social services and 44% were unemployed at the time of the interview. Thirty patients (94%) had HADS Depression Score≥11.

Conclusion: Survivors of severe trauma in our cohort had limited autonomy and need long-term rehabilitation. Most of them rely on private healthcare services with a significant financial impact on their family budget. Almost all patients had moderate to severe depression. Future post-ICU counseling services should facilitate access to rehabilitation and psychological support for these patients.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Critical Care
  • Female
  • Follow-Up Studies
  • Goals
  • Humans
  • Injury Severity Score
  • Long-Term Care
  • Male
  • Middle Aged
  • Patient Care Planning*
  • Stress Disorders, Post-Traumatic
  • Wounds and Injuries / psychology
  • Wounds and Injuries / rehabilitation
  • Wounds and Injuries / therapy*
  • Young Adult