National Parkinson Foundation Center of Excellence, University of California San Francisco, Neurology Department, CA, USA.
Parkinsonism Relat Disord. 2011 Mar;17(3):139-45. doi: 10.1016/j.parkreldis.2010.11.009. Epub 2010 Dec 14.
To review the literature and to identify practice gaps in the management of the hospitalized Parkinson's disease (PD) patient.
Patients with PD are admitted to hospitals at higher rates, and frequently have longer hospital stays than the general population. Little is known about outpatient interventions that might reduce the need for hospitalization and also reduce hospital-related complications.
A literature review was performed on PubMed about hospitalization and PD between 1970 and 2010. In addition, in press peer-reviewed papers or published abstracts known to the authors were included. Information was reviewed by a National Parkinson Foundation workgroup and a narrative review article was generated.
Motor disturbances in PD are believed to be a causal factor in the higher rates of admissions and complications. However, other conditions are commonly recorded as the primary reason for hospitalization including motor complications, reduced mobility, lack of compliance, inappropriate use of neuroleptics, falls, fractures, pneumonia, and other important medical problems. There are many relevant issues related to hospitalization in PD. Medications, dosages and specific dosage schedules are critical. Staff training regarding medications and medication management may help to avoid complications, particularly those related to reduced mobility, and aspiration pneumonia. Treatment of infections and a return to early mobility is also critical to management.
Educational programs, recommendations, and guidelines are needed to better train interdisciplinary teams in the management of the PD patient. These initiatives have the potential for both cost savings and improved outcomes from a preventative and a hospital management standpoint.
回顾文献并确定住院帕金森病（PD）患者管理方面的实践差距。
与普通人群相比，PD 患者住院率更高，住院时间也更长。对于可能减少住院需求并减少与住院相关的并发症的门诊干预措施知之甚少。
对 1970 年至 2010 年间在 PubMed 上发表的关于住院和 PD 的文献进行了综述。此外，还纳入了作者已知的即将出版的同行评审论文或已发表的摘要。信息由国家帕金森基金会工作组审查，并生成了一篇叙述性综述文章。
PD 中的运动障碍被认为是导致住院率和并发症更高的一个因果因素。然而，其他情况通常被记录为住院的主要原因，包括运动并发症、活动能力下降、不遵医嘱、神经阻滞剂使用不当、跌倒、骨折、肺炎和其他重要的医疗问题。PD 患者的住院问题有很多相关的问题。药物、剂量和特定的剂量方案至关重要。针对药物和药物管理进行员工培训可能有助于避免并发症，特别是那些与活动能力下降和吸入性肺炎相关的并发症。感染的治疗和尽早恢复活动能力对于管理也至关重要。
需要教育计划、建议和指南，以更好地培训跨学科团队管理 PD 患者。这些举措有可能从预防和医院管理的角度节省成本并改善结果。
