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High rates and the risk factors for emergency room visits and hospitalization in Parkinson's disease.

Abstract：

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.

journal_name

Parkinsonism Relat Disord

journal_title

Parkinsonism & related disorders

authors

Hassan A,Wu SS,Schmidt P,Dai Y,Simuni T,Giladi N,Bloem BR,Malaty IA,Okun MS,NPF-QII Investigators.

doi

10.1016/j.parkreldis.2013.06.006

subject

Has Abstract

pub_date

2013-11-01 00:00:00

pages

949-54

issue

11

eissn

1353-8020

issn

1873-5126

pii

S1353-8020(13)00224-1

journal_volume

19

pub_type

杂志文章,多中心研究

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