Persistent vegetative state and minimally conscious state units in France, current situation 10 years after their creation
| Autor: | James Charanton, J. Drigny, Aurélie Ruet, C. Kiefer, B. Albinet-Fournot, P. Pradat-Diehl |
|---|---|
| Rok vydání: | 2015 |
| Předmět: |
Disorders of consciousness
Patient discharge medicine.medical_specialty human ressources business.industry Traumatic brain injury Mortality rate medicine.medical_treatment Rehabilitation Minimally conscious state medicine.disease Health-care facilities Tracheotomy Health care Emergency medicine medicine Physical therapy Orthopedics and Sports Medicine business Stroke Persistent vegetative state |
| Zdroj: | Annals of Physical and Rehabilitation Medicine. 58:e58-e59 |
| ISSN: | 1877-0657 |
| DOI: | 10.1016/j.rehab.2015.07.144 |
| Popis: | Introduction Since May 2002, hospital care for Persistent Vegetative State (PVS) or Minimally Conscious State (MCS) patients in France are structured in dedicated units: PVS/MCS units. The aim of this survey is to analyze the current situation after 10 years. Method In 2012, the 135 health institutions with PVS/MCS units were contacted to fill out a questionnaire with information about health facilities, human resources, patients care pathways and characteristics. Results Fifty-one institutions (38%) answered the questionnaire. The PVS/MCS units had an average of 8.3 authorized beds (max–min: 4–19), for 8.1 available beds and a 97% bed occupation rate. They admitted on average 21 patients since their creation. Important disparities regarding staff resources existed between these Units. With regard to the 348 patients documented (mean age: 48.2; min: 13; max: 82), 36% were in PVS ans, 51% were in MCS, 10% had left MCS. Arousal state improved since admission for 25% and decreased for 1%. Initial pathology was traumatic brain injury for 35%, anoxic brain injury for 27%, stroke for 22%. Initially, 70% of the patients had quadriplegia, and 30% had hemiplegia, 88% of them had orthopedic complications. Among the patients, 45% had a tracheotomy and 92% had a digestive stomy. Mean length of stay was 4.5 years. The annual mortality rate was below 5%. Finally, 12% awaited another living unit because their state of consciousness had improved. Discussion/Conclusion Structured hospital care for Persistent Vegetative State (PVS) patients or Minimally Conscious State (MCS) in France appears adequate to meet the quality objectives fixed by the May 3rd, 2012 commission regarding health facilities, admission criteria and health care. Patients require important care and staff resources. Patient discharge from these units is frequently a problem in case of improvement because of a lack of adequate living places. |
| Databáze: | OpenAIRE |
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