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

Anhar Hassan, Samuel S. Wu, Peter Schmidt, Yunfeng Dai, Tanya Simuni, Nir Giladi, Bastiaan R. Bloem, Irene A. Malaty, Michael S. Okun

Research output: Contribution to journalArticle

27 Scopus citations

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.

Original languageEnglish (US)
Pages (from-to)949-954
Number of pages6
JournalParkinsonism and Related Disorders
Volume19
Issue number11
DOIs
StatePublished - Nov 1 2013

Keywords

  • Admissions
  • Comorbidities
  • Emergency care
  • Hospitalization
  • Parkinson's disease

ASJC Scopus subject areas

  • Neurology
  • Geriatrics and Gerontology
  • Clinical Neurology

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    Hassan, A., Wu, S. S., Schmidt, P., Dai, Y., Simuni, T., Giladi, N., Bloem, B. R., Malaty, I. A., & Okun, M. S. (2013). High rates and the risk factors for emergency room visits and hospitalization in Parkinson's disease. Parkinsonism and Related Disorders, 19(11), 949-954. https://doi.org/10.1016/j.parkreldis.2013.06.006