Shaibdat Navena Sharma, Ahmad Norfazilah, Azmin Shahrul, Ibrahim Norlinah Mohamed
Department of Medicine, Hospital Canselor Tuanku Muhriz, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia.
Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia.
Front Neurol. 2023 Mar 7;14:1136858. doi: 10.3389/fneur.2023.1136858. eCollection 2023.
Patients with Parkinson's disease (PD) are at a higher risk of hospital admissions compared to the general population. We studied the causes and factors associated with admissions among patients with PD over 6 years.
We included all PD admissions between 1 January 2016 and 31 December 2021. Other causes of parkinsonism were excluded. Causes of admissions were divided into PD-related (direct or indirect) or non-PD-related. The type of admission was categorized into emergency or elective.
We identified 605 hospital admissions (259 patients with PD); 345 (57.0%) were PD-related and 260 (43%) were non-PD-related. Emergency PD admissions contributed to 50.4% of all admissions, most commonly from respiratory infection (23%). PD admissions in comparison to non-PD admissions were associated with worse disease severity (HY ≥ 3; < 0.001), longer disease duration [8.71 (SD 6.23) vs. 6.60 (SD 5.39) years; < 0.001], and longer hospital stay [7.70 (SD 5.89) vs. 6.42 (SD 7.63) days; = 0.020]. Non-PD admissions were associated with more comorbidities (97.3%; = 0.013). There were 124 (20.5%) complications and 31 deaths (5.1%). A total of 29 deaths were due to respiratory infection and 3 deaths were due to COVID-19 pneumonia. Emergency admission (PD- and non-PD-related; = 0.001) and respiratory-related causes ( < 0.001) were predictors of unfavorable hospital admission outcomes (death and complications).
Respiratory infection was the leading cause of hospital admission and a significant independent predictor of unfavorable hospital admission outcomes (death and complications). PD-related admissions were associated with disease severity and led to more complications and longer hospital stays. Non-PD-related admissions were associated with comorbidities.
与普通人群相比，帕金森病（PD）患者住院风险更高。我们对6年间PD患者的住院原因及相关因素进行了研究。
纳入2016年1月1日至2021年12月31日期间所有PD患者的住院病例，排除帕金森综合征的其他病因。住院原因分为与PD相关（直接或间接）或与PD无关。住院类型分为急诊或择期。
共确定605例住院病例（259例PD患者）；345例（57.0%）与PD相关，260例（43%）与PD无关。急诊PD住院占所有住院病例的50.4%，最常见的原因是呼吸道感染（23%）。与非PD住院相比，PD住院与更严重的疾病严重程度（Hoehn-Yahr分级≥3级；P<0.001）、更长的病程[8.71（标准差6.23）年 vs. 6.60（标准差5.39）年；P<0.001]以及更长的住院时间[7.70（标准差5.89）天 vs. 6.42（标准差7.63）天；P=0.020]相关。非PD住院与更多合并症相关（97.3%；P=0.013）。共有124例（20.5%）出现并发症，31例（5.1%）死亡。其中29例死亡归因于呼吸道感染，3例死亡归因于新型冠状病毒肺炎。急诊住院（与PD相关和与PD无关；P=0.001）和呼吸道相关原因（P<0.001）是不良住院结局（死亡和并发症）的预测因素。
呼吸道感染是住院的主要原因，也是不良住院结局（死亡和并发症）的重要独立预测因素。与PD相关的住院与疾病严重程度相关，导致更多并发症和更长的住院时间。与PD无关的住院与合并症相关。
