School of Pharmacy, University of Eastern Finland, Kuopio, Finland.
Institute of Clinical Medicine/Neurology, University of Eastern Finland, Kuopio, Finland.
Eur J Neurol. 2023 Jun;30(6):1648-1657. doi: 10.1111/ene.15782. Epub 2023 Mar 26.
Fall-related injuries are a major health concern among people with Parkinson disease (PD). We compared the incidence and postinjury mortality of head injuries and traumatic brain injury (TBI) among persons with and without PD.
This register-based study was conducted on the FINPARK cohort, which includes 22,189 persons who were diagnosed with PD in Finland during 1996-2015. We excluded persons with a previous head injury, leaving 20,514 persons with PD. For each person with PD, 1-7 matching persons without PD and previous head injury were identified with respect to age, sex, and residence. The Cox proportional hazard model was used to estimate hazard ratios for head injury. A logistic regression model was used to compare mortality.
Persons with PD had 2.16-fold (95% confidence interval [CI] = 2.06-2.26) risk of all head injuries and 1.97-fold (95% CI = 1.84-2.10) risk of TBI after adjustment for age, sex, and comorbidities. Persons with PD had higher 1-year mortality after any type of head injury (adjusted odds ratio [aOR] = 1.44, 95% CI = 1.28-1.62), TBI (aOR = 1.33, 95% CI = 1.14-1.57), or non-TBI head injury (aOR = 1.72, 95% CI = 1.42-2.07) than persons without PD. The higher risk of mortality was observed 6 months after TBI and 1 month after non-TBI injury in persons with PD. Persons with PD and head injury also had higher 1-year mortality than persons with PD and without head injury.
Persons with PD have a higher risk of head injury and higher postinjury mortality than persons without PD.
跌倒相关损伤是帕金森病（PD）患者的主要健康问题。我们比较了有和没有 PD 的人群中头部损伤和创伤性脑损伤（TBI）的发生率和损伤后死亡率。
本研究基于 FINPARK 队列进行，该队列包括 1996 年至 2015 年期间在芬兰被诊断为 PD 的 22189 名患者。我们排除了有既往头部损伤的患者，留下 20514 名 PD 患者。对于每一位 PD 患者，根据年龄、性别和居住地匹配 1-7 名没有 PD 和既往头部损伤的患者。使用 Cox 比例风险模型估计头部损伤的风险比。使用逻辑回归模型比较死亡率。
调整年龄、性别和合并症后，PD 患者发生所有头部损伤的风险是无 PD 患者的 2.16 倍（95%置信区间 [CI] = 2.06-2.26），发生 TBI 的风险是无 PD 患者的 1.97 倍（95% CI = 1.84-2.10）。发生任何类型头部损伤后，PD 患者 1 年死亡率更高（调整后的优势比 [aOR] = 1.44，95% CI = 1.28-1.62）、TBI（aOR = 1.33，95% CI = 1.14-1.57）或非 TBI 头部损伤（aOR = 1.72，95% CI = 1.42-2.07）的风险均高于无 PD 患者。PD 患者 TBI 后 6 个月和非 TBI 损伤后 1 个月观察到更高的死亡率。发生头部损伤的 PD 患者 1 年死亡率也高于没有头部损伤的 PD 患者。
与无 PD 患者相比，PD 患者发生头部损伤的风险更高，损伤后死亡率更高。
