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重症监护病房中帕金森病患者的评估:一项队列研究。

Evaluation of Patients with Parkinson's Disease in Intensive Care Units: A Cohort Study.

作者信息

Réa-Neto Álvaro, Dal Vesco Bruna C, Bernardelli Rafaella S, Kametani Aline M, Oliveira Mirella C, Teive Hélio A G

机构信息

Center for Studies and Research in Intensive Care Medicine-CEPETI, Curitiba 82530-200, Brazil.

Internal Medicine Department, Hospital de Clínicas, Federal University of Paraná, Curitiba 80060-900, Brazil.

出版信息

Parkinsons Dis. 2021 Nov 5;2021:2948323. doi: 10.1155/2021/2948323. eCollection 2021.

Abstract

BACKGROUND

Parkinson's disease affects approximately 1% of the worldwide population older than 60 years. This number is estimated to double by 2030, increasing the global burden of the disease. Patients with Parkinson's disease are hospitalized 1.5 times more frequently and for longer periods than those without the disease, increasing health-related costs.

OBJECTIVE

To compare the characteristics and outcome of patients with and without Parkinson's disease admitted to intensive care units (ICUs).

METHODS

Historical cohort study of ICU admissions in a Brazilian city over 18 years. All patients with Parkinson's disease identified were matched for age, sex, year, and place of hospitalization with patients without the disease randomly selected from the same database.

RESULTS

The study included 231 patients with Parkinson's disease (PD group) and 462 controls without the disease (NPD group). Compared with patients in the NPD group, those in the PD group were more frequently admitted with lower level of consciousness and increased APACHE II severity score but required less frequently vasoactive drugs. In total, 42.4% of the patients in the PD group were admitted to the ICUs due to sepsis or trauma. Although these patients had longer hospital stay, the mortality rates were comparable between groups. Parkinson's disease was not associated with mortality, even when controlled for associated factors of disease severity.

CONCLUSION

Although patients with Parkinson's disease were admitted with higher severity scores and remained in the ICU for a longer time, their mortality rate was not higher than that in patients without the disease.

摘要

背景

帕金森病影响着全球约1%的60岁以上人口。据估计,到2030年这一数字将翻倍,从而增加该疾病的全球负担。帕金森病患者住院的频率比非帕金森病患者高1.5倍,住院时间也更长,这增加了与健康相关的费用。

目的

比较入住重症监护病房(ICU)的帕金森病患者与非帕金森病患者的特征及结局。

方法

对巴西一个城市18年期间入住ICU的患者进行历史性队列研究。从同一数据库中随机选取无帕金森病的患者,将所有确诊的帕金森病患者与这些患者在年龄、性别、年份和住院地点方面进行匹配。

结果

该研究纳入了231例帕金森病患者(PD组)和462例无帕金森病的对照者(NPD组)。与NPD组患者相比,PD组患者意识水平较低时入院的频率更高,急性生理与慢性健康状况评分系统(APACHE II)严重程度评分更高,但使用血管活性药物的频率更低。PD组中共有42.4%的患者因脓毒症或创伤入住ICU。尽管这些患者住院时间更长,但两组的死亡率相当。即使对疾病严重程度的相关因素进行控制,帕金森病也与死亡率无关。

结论

尽管帕金森病患者入院时严重程度评分更高,在ICU停留的时间更长,但其死亡率并不高于非帕金森病患者。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c6fc/8589523/cf162d831713/PD2021-2948323.001.jpg

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