TY - JOUR
T1 - High rates and the risk factors for emergency room visits and hospitalization in Parkinson's disease
AU - Hassan, Anhar
AU - Wu, Samuel S.
AU - Schmidt, Peter
AU - Dai, Yunfeng
AU - Simuni, Tanya
AU - Giladi, Nir
AU - Bloem, Bastiaan R.
AU - Malaty, Irene A.
AU - Okun, Michael S.
PY - 2013/11
Y1 - 2013/11
N2 - 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.
AB - 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.
KW - Admissions
KW - Comorbidities
KW - Emergency care
KW - Hospitalization
KW - Parkinson's disease
UR - http://www.scopus.com/inward/record.url?scp=84886592536&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84886592536&partnerID=8YFLogxK
U2 - 10.1016/j.parkreldis.2013.06.006
DO - 10.1016/j.parkreldis.2013.06.006
M3 - Article
C2 - 23835430
AN - SCOPUS:84886592536
SN - 1353-8020
VL - 19
SP - 949
EP - 954
JO - Parkinsonism and Related Disorders
JF - Parkinsonism and Related Disorders
IS - 11
ER -