Deterioration of Parkinson%26apos;s disease during hospitalization: survey of 684 patients

作者：Gerlach Oliver H H^*; Broen Martijn P G; van Domburg Peter H M F; Vermeij Ad J; Weber Wim E J

来源：BMC Neurology, 2012, 12: 13.

DOI：10.1186/1471-2377-12-13

Background: A substantial fraction of Parkinson%26apos;s disease patients deteriorate during hospitalisation, but the precise proportion and the reasons why have not been studied systematically and the focus has been on surgical wards and on Accident %26 Emergency departments. We assessed the prevalence and risk factors of deterioration of Parkinson%26apos;s disease symptoms during hospitalization, including all wards. %26lt;br%26gt;Methods: We invited Parkinson%26apos;s disease patients from three neurology departments in The Netherlands to answer a standardised questionnaire on general, disease and hospital related issues. Patients who had been hospitalized in the previous year were included and analysed. Possible risk factors for Parkinson%26apos;s disease deterioration were identified. Proportions were analysed using the Chi-Square test and a logistic regression analysis was performed. %26lt;br%26gt;Results: Eighteen percent of 684 Parkinson%26apos;s disease patients had been hospitalized at least once in the last year. Twenty-one percent experienced deterioration of motor symptoms, 33% did have one or more complications and 26% had received incorrect anti-Parkinson%26apos;s medication. There were no statistically significant differences for these variables between admissions on neurologic or non-neurologic wards and between having surgery or not. Incorrect medication during hospitalization was significantly associated with higher risk (OR 5.8, CI 2.5-13.7) of deterioration, as were having infections (OR 6.7 CI 1.8-24.7). A higher levodopa equivalent dose per day was a significant risk factor for deterioration. When adjusting for different variables, wrong medication distribution was the most important risk factor for deterioration. %26lt;br%26gt;Conclusions: Incorrect medication and infections are the important risk factors for deterioration of Parkinson%26apos;s disease patients both for admissions with and without surgery and both for admissions on neurologic and non-neurologic wards. Measures should be taken to improve care and incorporated in guidelines.

• 出版日期2012-3-8