Evaluation of disabilities and rehabilitation needs after critical illness: Impact of an intensive care unit follow-up clinic in the University Hospital of Angers

Objective After critical illness, some survivors experience long-term physical, functional, neurocognitive and/or mental health impairments, which has been termed “Post–Intensive Care syndrome” (PICS) [1] . A specific follow-up is required and many specialized follow-up clinics have been created both abroad and in France. The aim of this study is to evaluate long-term outcomes after critical illness, through the International Classification of Functioning, Disability and Health, and to analyse rehabilitation needs after intensive care unit (ICU) discharge. Material/patients and methods Adult intensive care patients (> 18 years old), mechanically ventilated for 5 days or more, were recruited. They were examined one month after ICU discharge by a multidisciplinary team including an intensivist, a nurse, a psychiatrist and a physical medicine and rehabilitation (PM&R) physician. Functional assessment included an orthopedic and neuromuscular examination, a functional evaluation of the upper limbs, a gait and balance evaluation, a six-minute walk test and a cognitive outcomes’ study. Diagnoses and rehabilitation needs were analyzed. Results Since April 2015, 15 patients were enrolled in the ICU follow-up clinic. Eight patients were diagnosed with thirteen rehabilitation needs: 2 rotator cuff tendinopathies, 4 peripheral neuropathies, 1 central nervous system disorder, 1 severe cognitive impairment and 5 exercise intolerances. Ten rehabilitation prescriptions were made: 4 renewals, 4 new liberal prescriptions and 2 inpatient rehabilitations. Advice was provided to ten patients (to continue basic activities of daily living, to do regular physical activity or self-exercises, driving advice). Discussion - conclusion The creation of an ICU follow-up clinic in University Hospital of Angers meets a health need by a personalized and comprehensive assessment of patients discharged from intensive care. This structure is functional and allows an adaptation of the management of long-term disabilities after critical illness.