Caractéristiques médicales et sociales et trajectoires de soins des patients cérébro-lésés hospitalisés

Abstract

The study objective was to better understand the clinical and social characteristics, and the treatment plans, of brain-damaged patients who were hospitalized longer than one month in acute care units. A 6-month descriptive prospective epidemiological study of 90 patients was carried out. The average length of stay (LOS) was 84 ±73 days. Patients were severely disabled: 17.83 % of patients showed a Glasgow Outcome Scale (GOS) 2, 70% a GOS 3 and 12.2 %, a GOS≥4. Two-thirds of the patients had social difficulties that influenced their LOS (68.4 days when social difficulties <3, versus 157.4 days when ≥3). An average of 4 rehabilitation settings were solicited per patient. The actual rehabilitation setting matched the patient's and team's wishes in only 63.4 % of the cases. Several proposals are discussed to improve overall management of care for brain-damaged patients: the need to establish a mobile steering team, to improve multidisciplinary approaches, and to create acute physical medicine and rehabilitation units.