title: Aetiologies, comorbidities and causes of death in a population of 133 patients with polyhandicaps cared for at specialist rehabilitation centres.
abstract: OBJECTIVE
  This study concerns the aetiologies, comorbidities and places and causes of death of a population of persons with severe polyhandicap (PLH).
  
  
  METHODS
  Based on the medical files of all deceased PLH patients, who were cared for between 2006-2012. Data collected were aetiological diagnosis of the polyhandicap, duration and type of hospitalization, age, place and cause of death, comorbidities: chronic respiratory insufficiency, recurrent attacks of pulmonary infections, urinary infections, active epilepsy, scoliosis, chronic digestive disorders and behavioural problems.
  
  
  RESULTS
  One hundred and thirty-three patients died, 70 children and 63 adults. The sex ratio was 84 men to 49 women. The average stay in these institutions was 10 years 4 months. The average age at the time of death was 21 years, in 60% of cases the place of death was in the specialist rehabilitation centres. The causes of death in decreasing order were: pulmonary infections (63.2%), sudden death (18%) and status epilepticus (6.8%); 79.7% of patients suffered from chronic respiratory insufficiency, 60.2% suffered serious scoliosis, 66.9% drug-resistant epilepsy and 78.9% had digestive disorders. The main aetiologies of the polyhandicap were: pre- and perinatal encephalopathies (31.6%), metabolic encephalopathies (18%) and convulsive encephalopathies (11.3%).
  
  
  CONCLUSIONS
  The main comorbidity and main cause of death in patients with severe PLH is respiratory failure.
authors.affiliation: Fédération des Hôpitaux de Polyhandicap et Multihandicap .
authors.forename: M C
authors.initials: MC
authors.lastname: Rousseau
authors.forename: S
authors.initials: S
authors.lastname: Mathieu
authors.forename: C
authors.initials: C
authors.lastname: Brisse
authors.forename: M
authors.initials: M
authors.lastname: Motawaj
authors.forename: E
authors.initials: E
authors.lastname: Grimont
authors.forename: P
authors.initials: P
authors.lastname: Auquier
authors.forename: Th
authors.initials: T
authors.lastname: Billette de Villemeur
mesh_terms: D000293:Adolescent; D000328:Adult; D002423:Cause of Death; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease / Q000401:mortality*; D015897:Comorbidity; D006233:Persons with Disabilities / Q000534:rehabilitation; D004827:Epilepsy / Q000401:mortality; D005260:Female; D005500:Follow-Up Studies; D005602:France / Q000453:epidemiology; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008607:Intellectual Disability / Q000401:mortality; D007902:Length of Stay; D008171:Lung Diseases / Q000401:mortality; D008297:Male; D001523:Mental Disorders / Q000401:mortality; D008605:Mental Health Services; D008875:Middle Aged; D010343:Patient Admission; D012047:Rehabilitation Centers / Q000706:statistics & numerical data; D012600:Scoliosis / Q000401:mortality; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D014552:Urinary Tract Infections / Q000401:mortality
keywords: Comorbidities; death; handicap; polyhandicap