Michal Lubomski1, R Louise Rushworth2, Stephen Tisch1. 1. The University of Notre Dame Australia, School of Medicine, Sydney, New South Wales, Australia Department of Neurology, St Vincent's Hospital, Sydney, New South Wales, Australia. 2. The University of Notre Dame Australia, School of Medicine, Sydney, New South Wales, Australia.
Abstract
OBJECTIVES: Patients with Parkinson's disease (PD) require higher levels of care during hospitalisation. Management of comorbidities in these patients aims to optimise function while minimising complications. The objective of this study was to examine patterns of hospitalisation of patients with PD in NSW with regards to sociodemographic factors, comorbidities and aspects of clinical management. METHODS: A retrospective study of all patients with idiopathic PD and a control group of non-PD patients admitted for acute care to NSW hospitals between 2008 and 2012. RESULTS: The study group comprised 5637 cases and 8143 controls. The mean PD patient age was 75.0 years (±10.9). Patients with PD had a significantly longer hospital stay (median 7 days, IQR 3-13 vs 1 day, IQR 1-7, p<0.001) than control patients. Patients with PD were five times more likely to be treated for delirium, three times more likely to experience an adverse drug event and syncope, more than twice as likely to require management of falls/fractures, dementia, gastrointestinal complications, genitourinary infections, reduced mobility and other trauma but half as likely to require hospitalisation for chronic airways disease and neoplasia, including melanoma, than the control group (all p<0.001). CONCLUSIONS: Patients with PD are more likely to suffer serious health problems, including delirium, adverse drug reactions, syncope, falls and fractures than controls. These findings highlight PD as a multisystem neuropsychiatric disorder in which motor and non-motor features contribute to morbidity. Increased awareness of the added risk PD poses in acute hospitalised patients can be used to inform strategies to improve patient outcomes. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
OBJECTIVES:Patients with Parkinson's disease (PD) require higher levels of care during hospitalisation. Management of comorbidities in these patients aims to optimise function while minimising complications. The objective of this study was to examine patterns of hospitalisation of patients with PD in NSW with regards to sociodemographic factors, comorbidities and aspects of clinical management. METHODS: A retrospective study of all patients with idiopathic PD and a control group of non-PDpatients admitted for acute care to NSW hospitals between 2008 and 2012. RESULTS: The study group comprised 5637 cases and 8143 controls. The mean PDpatient age was 75.0 years (±10.9). Patients with PD had a significantly longer hospital stay (median 7 days, IQR 3-13 vs 1 day, IQR 1-7, p<0.001) than control patients. Patients with PD were five times more likely to be treated for delirium, three times more likely to experience an adverse drug event and syncope, more than twice as likely to require management of falls/fractures, dementia, gastrointestinal complications, genitourinary infections, reduced mobility and other trauma but half as likely to require hospitalisation for chronic airways disease and neoplasia, including melanoma, than the control group (all p<0.001). CONCLUSIONS:Patients with PD are more likely to suffer serious health problems, including delirium, adverse drug reactions, syncope, falls and fractures than controls. These findings highlight PD as a multisystem neuropsychiatric disorder in which motor and non-motor features contribute to morbidity. Increased awareness of the added risk PD poses in acute hospitalised patients can be used to inform strategies to improve patient outcomes. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
Authors: Stella M Papa; Patrik Brundin; Victor S C Fung; Un Jung Kang; David J Burn; Carlo Colosimo; Han-Lin Chiang; Roy N Alcalay; Claudia Trenkwalder Journal: Mov Disord Date: 2020-04-16 Impact factor: 10.338
Authors: Stella M Papa; Patrik Brundin; Victor S C Fung; Un Jung Kang; David J Burn; Carlo Colosimo; Han-Lin Chiang; Roy N Alcalay; Claudia Trenkwalder Journal: Mov Disord Clin Pract Date: 2020-04-16