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Rivista di Anestesia, Rianimazione, Terapia Antalgica e Terapia Intensiva
Minerva Anestesiologica 2016 Gennaio;82(1):22-9
Defining needs and goals of post-ICU care for trauma patients: preliminary study
Maria G. BOCCI 1, Domenico L. GRIECO 1, Serena LOCHI 1, Laura MINGUELL DEL LUNGO 1, Gabriele PINTAUDI 1, Anselmo CARICATO 1, Rita MURRI 2, Claudia CALABRESE 1, Antonio G. DE BELVIS 3, Maria AVOLIO 3, Claudio SANDRONI 1, Massimo ANTONELLI 1 ✉
1 Department of Anesthesiology and Intensive Care Medicine, Sacro Cuore Catholic University, Rome, Italy; 2 Department of Infectious Diseases, Sacro Cuore Catholic University, Rome, Italy; 3 Department of Hygiene and Public Health, Sacro Cuore Catholic University, Rome, Italy
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.