title: Defining needs and goals of post-ICU care for trauma patients: preliminary study.
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.
  
  
  CONCLUSIONS
  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.
authors: Department of Anesthesiology and Intensive Care Medicine, Sacro Cuore Catholic University, Rome, Italy - dlgrieco@ymail.com.
authors: Maria G
authors: MG
authors: Bocci
authors: Domenico L
authors: DL
authors: Grieco
authors: Serena
authors: S
authors: Lochi
authors: Laura
authors: L
authors: Minguell Del Lungo
authors: Gabriele
authors: G
authors: Pintaudi
authors: Anselmo
authors: A
authors: Caricato
authors: Rita
authors: R
authors: Murri
authors: Claudia
authors: C
authors: Calabrese
authors: Antonio G
authors: AG
authors: DE Belvis
authors: Maria
authors: M
authors: Avolio
authors: Claudio
authors: C
authors: Sandroni
authors: Massimo
authors: M
authors: Antonelli
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003422:Critical Care; D005260:Female; D005500:Follow-Up Studies; D006040:Goals; D006801:Humans; D015601:Injury Severity Score; D008134:Long-Term Care; D008297:Male; D008875:Middle Aged; D010347:Patient Care Planning; D013313:Stress Disorders, Post-Traumatic; D014947:Wounds and Injuries / Q000523:psychology / Q000534:rehabilitation / Q000628:therapy*; D055815:Young Adult