Department of Epidemiology, College of Public Health, University of Nebraska Medical Center, Omaha, Nebraska, USA.
Department of Neurology, Shanghai Minhang District Central Hospital, Shanghai, China.
Neuroepidemiology. 2018;50(1-2):7-17. doi: 10.1159/000484410. Epub 2017 Dec 22.
BACKGROUND/AIMS: In 1996, Nebraska became the first state in the United States to establish a Parkinson's disease (PD) Registry. The objectives of this study were to determine the most common comorbid conditions among PD patients receiving inpatient and outpatient services in Nebraska between 2004 and 2012, and to examine whether PD patients had increased risks of these conditions.
Statewide linkage was performed between Nebraska PD Registry data and hospital discharge database. The cohort comprised of 3,852 PD inpatients and 19,260 non-PD inpatients, and 5,217 PD outpatients and 26,085 non-PD outpatients. Referent subjects were matched to PD patients by age at initial hospital admissions or visits, gender, and county of residence using systematic random-sampling method.
Compared to non-PD inpatients, PD inpatients were at higher risks for dementia (relative risk [RR] 2.29; 95% CI 2.14-2.45), mood disorders (RR 1.57; 95% CI 1.44-1.70), gastrointestinal disorders (RR 1.15; 95% CI 1.06-1.25), and urinary tract infections (RR 1.33; 95% CI 1.22-1.45), while PD outpatients had higher risks for spondylosis (RR 1.23; 95% CI 1.09-1.38), genitourinary disorders (RR 1.48; 95% CI 1.29-1.69), gastrointestinal disorders (RR 1.59; 95% CI 1.38-1.84), and dementia (RR 2.83; 95% CI 2.38-3.37) than non-PD outpatients.
The findings highlight PD as a multisystem neurodegenerative disorder, and this information is crucial for creating strategies to better prevent and manage PD complications.
背景/目的:1996 年,内布拉斯加州成为美国第一个建立帕金森病(PD)登记处的州。本研究的目的是确定 2004 年至 2012 年内布拉斯加州接受住院和门诊服务的 PD 患者中最常见的合并症,并检查 PD 患者是否存在这些疾病的风险增加。
在全州范围内,将内布拉斯加州 PD 登记处的数据与医院出院数据库进行了链接。该队列包括 3852 名 PD 住院患者和 19260 名非 PD 住院患者,以及 5217 名 PD 门诊患者和 26085 名非 PD 门诊患者。参照患者通过初始住院或就诊时的年龄、性别和居住县,采用系统随机抽样方法与 PD 患者进行匹配。
与非 PD 住院患者相比,PD 住院患者痴呆(相对风险 [RR] 2.29;95%置信区间 [CI] 2.14-2.45)、情绪障碍(RR 1.57;95% CI 1.44-1.70)、胃肠道疾病(RR 1.15;95% CI 1.06-1.25)和尿路感染(RR 1.33;95% CI 1.22-1.45)的风险更高,而 PD 门诊患者患脊柱疾病(RR 1.23;95% CI 1.09-1.38)、泌尿生殖系统疾病(RR 1.48;95% CI 1.29-1.69)、胃肠道疾病(RR 1.59;95% CI 1.38-1.84)和痴呆(RR 2.83;95% CI 2.38-3.37)的风险高于非 PD 门诊患者。
这些发现突出了 PD 作为一种多系统神经退行性疾病的特征,这些信息对于制定更好地预防和管理 PD 并发症的策略至关重要。