BACKGROUND: Parkinson's disease (PD) patients are hospitalized more frequently than their peers as a result of falls, psychosis, infections and other medical complications. However, patient-specific risk factors for hospitalization are unclear. OBJECTIVE: To identify rates and risk factors for hospital encounters (Emergency Room [ER] visits or hospitalization) among people with PD. METHODS: 3415 PD participants (mean age 67 ± 10 years, disease duration 9 ± 6 years, H&Y 2 47%, H&Y 3 26%) enrolled in the prospective international multicenter NPF-QII Study. One-year follow-up data was available for 1030 patients. Rates and risk factors for hospital encounters were determined at baseline and after one year follow-up. RESULTS: Of 3415 PD participants at study entry, 1120 (33%) reported at least one hospital encounter. Associations were: longer timed up-and-go test (OR: 1.33), increased comorbidities (OR: 1.25), motor fluctuations (OR: 1.32), and deep brain stimulation (DBS) (OR: 2.49). Of these 1120 persons, 311 had follow-up data and 158 (51%) had a repeat encounter one year later, associated with higher H&Y stage, fluctuations, and lower health-related quality-of-life. Of 2295 participants without a hospital encounter at baseline, 719 had follow-up data and 178 (25%) had a first hospital encounter one year later. Risk factors were female gender, comorbidities, lower cognition, fluctuations, and DBS. CONCLUSIONS: One-third of people with PD had a hospital encounter each year, and one-half of those had a repeat encounter. These high rates correlated with disease severity, comorbidities and DBS. There is an urgent need to develop programs to reduce PD hospital encounters.
BACKGROUND:Parkinson's disease (PD) patients are hospitalized more frequently than their peers as a result of falls, psychosis, infections and other medical complications. However, patient-specific risk factors for hospitalization are unclear. OBJECTIVE: To identify rates and risk factors for hospital encounters (Emergency Room [ER] visits or hospitalization) among people with PD. METHODS: 3415 PDparticipants (mean age 67 ± 10 years, disease duration 9 ± 6 years, H&Y 2 47%, H&Y 3 26%) enrolled in the prospective international multicenter NPF-QII Study. One-year follow-up data was available for 1030 patients. Rates and risk factors for hospital encounters were determined at baseline and after one year follow-up. RESULTS: Of 3415 PDparticipants at study entry, 1120 (33%) reported at least one hospital encounter. Associations were: longer timed up-and-go test (OR: 1.33), increased comorbidities (OR: 1.25), motor fluctuations (OR: 1.32), and deep brain stimulation (DBS) (OR: 2.49). Of these 1120 persons, 311 had follow-up data and 158 (51%) had a repeat encounter one year later, associated with higher H&Y stage, fluctuations, and lower health-related quality-of-life. Of 2295 participants without a hospital encounter at baseline, 719 had follow-up data and 178 (25%) had a first hospital encounter one year later. Risk factors were female gender, comorbidities, lower cognition, fluctuations, and DBS. CONCLUSIONS: One-third of people with PD had a hospital encounter each year, and one-half of those had a repeat encounter. These high rates correlated with disease severity, comorbidities and DBS. There is an urgent need to develop programs to reduce PD hospital encounters.
Authors: Daniel Martinez-Ramirez; Juan C Giugni; Leonardo Almeida; Roger Walz; Bilal Ahmed; Fiona A Chai; Valerie Rundle-Gonzalez; Alberto R Bona; Erin Monari; Aparna Wagle Shukla; Christopher W Hess; Chris J Hass; Michael S Okun Journal: J Neurol Date: 2015-10-29 Impact factor: 4.849
Authors: Danielle S Abraham; Thanh Phuong Pham Nguyen; Sean Hennessy; Daniel Weintraub; Shelly L Gray; Dawei Xie; Allison W Willis Journal: Age Ageing Date: 2020-08-24 Impact factor: 10.668
Authors: Jori Fleisher; William Barbosa; Meghan M Sweeney; Sarah E Oyler; Amy C Lemen; Arash Fazl; Mia Ko; Talia Meisel; Naomi Friede; Geraldine Dacpano; Rebecca M Gilbert; Alessandro Di Rocco; Joshua Chodosh Journal: J Am Geriatr Soc Date: 2018-04-02 Impact factor: 5.562
Authors: Christopher G Tarolli; Grace A Zimmerman; Peggy Auinger; Scott McIntosh; Robert K Horowitz; Benzi M Kluger; E Ray Dorsey; Robert G Holloway Journal: Neurol Clin Pract Date: 2019-11-18
Authors: Camille P Vaughan; Lindsay P Prizer; Ann E Vandenberg; Felicia C Goldstein; Lynn Marie Trotti; Adriana P Hermida; Stewart A Factor Journal: Mov Disord Clin Pract Date: 2017-06-15