Primary and Community Care, Radboud University Medical Center, Nijmegen, the Netherlands; Groenhuysen Organisation, Roosendaal, the Netherlands.
Delft University of Technology, Pattern Recognition & Bioinformatics, Delft, the Netherlands.
Parkinsonism Relat Disord. 2022 Nov;104:123-128. doi: 10.1016/j.parkreldis.2022.10.012. Epub 2022 Oct 19.
Unplanned hospital admissions associated with Parkinson's disease could be partly attributable to comorbidities.
We studied nationwide claims databases and registries. Persons with newly diagnosed Parkinson's disease were identified based on the first Parkinson's disease-related reimbursement claim by a medical specialist. Comorbidities were classified based on the Charlson Comorbidity Index. We studied hospitalization admissions because of falls, psychiatric diseases, pneumonia and urinary tract infections, PD-related hospitalizations-not otherwise specified. The association between comorbidities and time-to-hospitalization was estimated using Cox proportional hazard modelling. To better understand pathways leading to hospitalizations, we performed multiple analyses on causes for hospitalizations.
We identified 18 586 people with newly diagnosed Parkinson's disease. The hazard of hospitalization was increased in persons with peptic ulcer disease (HR 2.20, p = 0.009), chronic obstructive pulmonary disease (HR 1.61, p < 0.001), stroke (HR 1.37, p = 0.002) and peripheral vascular disease (HR 1.31, p = 0.02). In the secondary analyses, the hazard of PD-related hospitalizations-not otherwise specified (HR 3.24, p = 0.02) and pneumonia-related hospitalization (HR 2.90, p = 0.03) was increased for those with comorbid peptic ulcer disease. The hazard of fall-related hospitalization (HR 1.57, p = 0.003) and pneumonia-related hospitalization (HR 2.91, p < 0.001) was increased in persons with chronic obstructive pulmonary disease. The hazard of pneumonia-related hospitalization was increased in those with stroke (HR 1.54, p = 0.03) or peripheral vascular disease (HR 1.60, p = 0.02). The population attributable risk of comorbidity was 8.4%.
Several comorbidities increase the risk of Parkinson's disease related-hospitalization indicating a need for intervention strategies targeting these comorbid disorders.
与帕金森病相关的非计划性住院治疗部分归因于合并症。
我们研究了全国性的索赔数据库和登记处。通过医疗专家的首次帕金森病相关报销索赔来确定新诊断为帕金森病的患者。合并症是根据 Charlson 合并症指数分类的。我们研究了因跌倒、精神疾病、肺炎和尿路感染、帕金森病相关的非特定住院治疗而住院的情况。使用 Cox 比例风险模型估计合并症与住院时间之间的关联。为了更好地了解导致住院的途径，我们对住院的原因进行了多次分析。
我们确定了 18586 名新诊断为帕金森病的患者。患有消化性溃疡病（HR 2.20，p=0.009）、慢性阻塞性肺疾病（HR 1.61，p<0.001）、中风（HR 1.37，p=0.002）和外周血管疾病（HR 1.31，p=0.02）的患者住院的风险增加。在次要分析中，患有合并消化性溃疡病的患者帕金森病相关的非特定住院治疗（HR 3.24，p=0.02）和肺炎相关的住院治疗（HR 2.90，p=0.03）的风险增加。患有慢性阻塞性肺疾病的患者跌倒相关住院治疗（HR 1.57，p=0.003）和肺炎相关住院治疗（HR 2.91，p<0.001）的风险增加。患有中风或外周血管疾病的患者肺炎相关住院治疗的风险增加（HR 1.54，p=0.03；HR 1.60，p=0.02）。合并症的人群归因风险为 8.4%。
几种合并症增加了患帕金森病相关住院治疗的风险，表明需要针对这些合并症采取干预策略。
