Post-intensive care consultation in neuro-injured patients: current practices and future directions

Survival after intensive care has markedly improved over the past decade. Yet for many patients, discharge from the ICU is not an endpoint but a transition toward a prolonged recovery marked by physical, cognitive, and psychological sequelae grouped under post-intensive care syndrome (PICS). In neuro-injured patients, this trajectory is even more complex, as ICU-related impairments intertwine with the consequences of the initial brain injury, frequently masked by anosognosia and invisible disabilities. We aimed to describe current practices of post-intensive care consultations for neuro-injured patients in France, assess their adequacy for this specific population, and identify areas for improvement. We conducted a national retrospective survey using an online questionnaire disseminated through professional societies in anesthesiology, intensive care, and neuroresuscitation. Data focused on organizational modalities, timing, perceived utility, and assessment tools used during post-ICU consultations. Among responding centers, fewer than 40% reported offering post-ICU consultations. When implemented, consultations were usually single, physician-led visits occurring approximately five months after ICU discharge. While clinicians largely considered these consultations highly useful for patients and teams alike, most felt that current formats were suboptimal. Subarachnoid hemorrhage and traumatic brain injury were the most frequently followed conditions. A clear mismatch emerged between scales currently used and those physicians deemed most appropriate, particularly for cognitive and psychological assessment. Post-ICU consultations for neuro-injured patients remain insufficiently developed and heterogeneous in France, despite strong clinician endorsement. Our findings highlight an urgent need for structured, multidisciplinary follow-up pathways tailored to neurological patients. Strengthening these consultations may improve long-term outcomes, support caregivers, and reinforce continuity between neurocritical care and community-based medicine.