Rousseau M C, Mathieu S, Brisse C, Motawaj M, Grimont E, Auquier P, Billette de Villemeur Th
Fédération des Hôpitaux de Polyhandicap et Multihandicap .
Brain Inj. 2015;29(7-8):837-42. doi: 10.3109/02699052.2015.1004757. Epub 2015 May 7.
This study concerns the aetiologies, comorbidities and places and causes of death of a population of persons with severe polyhandicap (PLH).
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.
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%).
The main comorbidity and main cause of death in patients with severe PLH is respiratory failure.
本研究关注重度多重残疾人群（PLH）的病因、合并症以及死亡地点和原因。
基于2006年至2012年期间所有已故PLH患者的医疗档案。收集的数据包括多重残疾的病因诊断、住院时间和类型、年龄、死亡地点和原因、合并症：慢性呼吸功能不全、肺部感染反复发作、泌尿系统感染、活动性癫痫、脊柱侧弯、慢性消化系统疾病和行为问题。
133名患者死亡，其中70名儿童和63名成人。男女比例为84名男性对49名女性。在这些机构的平均停留时间为10年4个月。死亡时的平均年龄为21岁，60%的死亡地点是在专科康复中心。死亡原因按降序排列为：肺部感染（63.2%）、猝死（18%）和癫痫持续状态（6.8%）；79.7%的患者患有慢性呼吸功能不全，60.2%患有严重脊柱侧弯，66.9%患有耐药性癫痫，78.9%患有消化系统疾病。多重残疾的主要病因是：产前和围产期脑病（31.6%）、代谢性脑病（18%）和惊厥性脑病（11.3%）。
重度PLH患者的主要合并症和主要死亡原因是呼吸衰竭。
