Umer Akbar1, Bhavpreet Dham2, Ying He3, Nawaz Hack4, Samuel Wu5, Michelle Troche6, Patrick Tighe7, Eugene Nelson8, Joseph H Friedman1, Michael S Okun9. 1. Department of Neurology, Brown University, Providence, RI, USA. 2. Department of Neurology, Drexel University, Philadelphia, PD, USA. 3. Department of Mathematics, Clarkson University, NY, USA. 4. US Naval Hospital, Okinawa, Japan. 5. Department of Biostatistics, University of Florida, Gainesville, FL, USA. 6. Department of Speech and Language Pathology, University of Florida, Gainesville, FL, USA. 7. Department of Anesthesiology, University of Florida, Gainesville, FL, USA. 8. Community & Family Medicine and of Dartmouth Institute, NH, USA. 9. Department of Neurology, University of Florida, Gainesville, FL, USA. Electronic address: okun@neurology.ufl.edu.
Abstract
INTRODUCTION: Careful examination of long-term analyses and trends is essential in understanding the medico-economic burden of this common complication. We sought to describe the long-term (32-year) trends of incidence and mortality in PD patients hospitalized with aspiration pneumonia (AsPNA). METHODS: Incidence and mortality of AsPNA in hospitalized PD versus non-PD patients was assessed by logistic regression analysis applied to a national database between the years 1979 and 2010. Covariates such as age-decennium, gender, year AsPNA occurred, and the interactions with PD diagnosis were investigated. Rate of AsPNA and mortality over the 32-years was trended and compared. RESULTS: AsPNA occurred in 3.6% of PD patients and 1.0% of non-PD patients. The average mortality for PD patients was less (17% vs. 22%). Long-term (32-year) trends revealed a nearly 10-fold increase in incidence of AsPNA in PD (0.4% in 1979, 4.9% in 2010), decreasing mortality overtime, higher likelihood in males, and increasing average age of AsPNA patients (steeper increase in PD). All p-values<0.05. In regression analysis, each successive year had a slight increase in odds of AsPNA (OR 1.03 in PD, OR1.06 in non-PD). CONCLUSIONS: Trends over 32 years revealed a 10-fold increase in AsPNA among PD and non-PD patients, and an associated decrease in mortality. Our data suggest that PD patients are living longer, have slightly more AsPNA, but a lower mortality than was seen in past decades. Further research should investigate the causes of AsPNA in PD, and also potential interventions to decrease its occurrence.
INTRODUCTION: Careful examination of long-term analyses and trends is essential in understanding the medico-economic burden of this common complication. We sought to describe the long-term (32-year) trends of incidence and mortality in PDpatients hospitalized with aspiration pneumonia (AsPNA). METHODS: Incidence and mortality of AsPNA in hospitalized PD versus non-PDpatients was assessed by logistic regression analysis applied to a national database between the years 1979 and 2010. Covariates such as age-decennium, gender, year AsPNA occurred, and the interactions with PD diagnosis were investigated. Rate of AsPNA and mortality over the 32-years was trended and compared. RESULTS: AsPNA occurred in 3.6% of PDpatients and 1.0% of non-PDpatients. The average mortality for PDpatients was less (17% vs. 22%). Long-term (32-year) trends revealed a nearly 10-fold increase in incidence of AsPNA in PD (0.4% in 1979, 4.9% in 2010), decreasing mortality overtime, higher likelihood in males, and increasing average age of AsPNA patients (steeper increase in PD). All p-values<0.05. In regression analysis, each successive year had a slight increase in odds of AsPNA (OR 1.03 in PD, OR1.06 in non-PD). CONCLUSIONS: Trends over 32 years revealed a 10-fold increase in AsPNA among PD and non-PDpatients, and an associated decrease in mortality. Our data suggest that PDpatients are living longer, have slightly more AsPNA, but a lower mortality than was seen in past decades. Further research should investigate the causes of AsPNA in PD, and also potential interventions to decrease its occurrence.
Authors: Teresa Pitts; Karen Wheeler Hegland; Christine M Sapienza; Donald C Bolser; Paul W Davenport Journal: Respir Physiol Neurobiol Date: 2016-04-16 Impact factor: 1.931
Authors: Bastiaan R Bloem; Jan H L Ypinga; Allison Willis; Colleen G Canning; Roger A Barker; Marten Munneke; Nienke M De Vries Journal: J Parkinsons Dis Date: 2018 Impact factor: 5.568
Authors: Duk Soo Kim; Richard N Jones; Theresa I Shireman; Benzi M Kluger; Joseph H Friedman; Umer Akbar Journal: Clin Park Relat Disord Date: 2020-12-23