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

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

33 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 2013

Keywords

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

ASJC Scopus subject areas

  • Neurology
  • Geriatrics and Gerontology
  • Clinical Neurology

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