Days Spent at Home and Mortality After Critical Illness: A Cluster Analysis Using Nationwide Data

BACKGROUND: Beyond the question of short-term survival, days spent at home could be considered a patient-centered outcome in critical care trials. RESEARCH QUESTION: What are the days spent at home and healthcare trajectories during the year after surviving critical illness? STUDY DESIGN AND METHODS: Data were extracted on adult survivors spending at least two nights in a French intensive care unit (ICU) during 2018 who were treated with invasive mechanical ventilation and/or vasopressors or inotropes. Trauma, burn, organ transplant, stroke and neurosurgical patients were excluded. Stays at home, death, hospitalizations were reported before and after ICU stay, using state sequence analysis. An unsupervised clustering method was performed to identify cohorts based on post-ICU trajectories. RESULTS: Of 77,132 ICU survivors, 89% returned home. In the year post-discharge, these patients spent a median 330 (IQR 283-349) days at home. At one year, 77% of patients were still at home and 17% had died. Fifty-one percent had been re-hospitalized and 10% required a further ICU admission. Forty-eight percent used rehabilitation facilities and 5.7% hospital at home. Three clusters of patients with distinct post-ICU trajectories were identified. Patients in cluster 1 (68% of total) survived and spent most of the year at home (338 (323-354) days). Patients in cluster 2 (18%) had more complex trajectories but most could return home (91%), spending 242 (174-277) days at home. Patients in cluster 3 (14%) died with only 37% returning home for 45 (15-90) days. INTERPRETATION: Many patients had complex healthcare trajectories after surviving critical illness. Wide variations in the ability to return home after ICU discharge was observed between clusters, which represents an important patient-centered outcome

Les Déterminants de la popularité entre la droite populiste et la gauche communiste en France

L’objectif de cet article est l’élaboration d’un modèle visant à déterminer les variables susceptibles d’influencer la fonction de popularité des partis de la gauche communiste et de la droite populiste en France. Le cas français est particulièrement intéressant, puisque ces courants ont une visibilité et un poids électoral très forts. L’originalité de ce travail consiste en l’introduction de variables en dehors du champ politico-économique. Nous utilisons des données subjectives (« confiance des ménages ») et des variables sécuritaires (« atteintes aux biens »). Les résultats sont très significatifs pour ces variables à la fois sur le long que sur le court terme. / The aim of this article is to build a model to determine the variables which influence the popularity function of right populist parties and left communism parties in France. The French case is very interesting because of the electoral weight of these parties. The originality of this work consists in the introduction of variables out of the political-economic space. We use subjective data (« Household confidence ») and security variables (« Damages to goods »). The results are very significant for these variables for long and short run.info:eu-repo/semantics/publishe

Fonction de popularité, hypothèse de responsabilité et dynamique des partis. Le cas français

This note looks at the popularity of the executive (Prime Minister and President of the Republic) and parties of power (ump and ps) in France. The aim is twofold: on the one hand to test the influence of economic, socio-economic and politic variables on the popularity of Prime Minister and the President to know who is most responsible and secondly to know the dynamics of power?s parties. Our results show that the newly introduced variables are significant and confirm the greater sensitivity of the popularity of Prime Minister vis-à-vis the economic deteriorations compared to that of the President of the Republic. However, if the ruling party also appears to be responsible, the opposition party does not take advantage of the deteriorating economic conditions. Classification JEL : C30, D72

One-Year Survival and Hospital-Free Days in Critically Illness After Viral Pneumonia

Survivors from critical illness frequently suffer from persistent symptoms and impaired functional status (1, 2). Little is known on long-term outcomes from critical illness specifically related to viral pneumonia. The ability to return home and hospital-free days (HFDs) are important patient-centered outcomes (3–6). In this study, we investigated one-year outcomes (mortality, return to home, and HFDs) in survivors requiring Intensive Care Unit (ICU) admission for seasonal influenza or COVID-19