Deterioration of Parkinsons disease during hospitalization: survey of 684 patientsReport as inadecuate

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BMC Neurology

, 12:13

First Online: 08 March 2012Received: 05 September 2011Accepted: 08 March 2012


BackgroundA substantial fraction of Parkinson-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 and Emergency departments. We assessed the prevalence and risk factors of deterioration of Parkinson-s disease symptoms during hospitalization, including all wards.

MethodsWe invited Parkinson-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-s disease deterioration were identified. Proportions were analysed using the Chi-Square test and a logistic regression analysis was performed.

ResultsEighteen percent of 684 Parkinson-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-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.

ConclusionsIncorrect medication and infections are the important risk factors for deterioration of Parkinson-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.

Electronic supplementary materialThe online version of this article doi:10.1186-1471-2377-12-13 contains supplementary material, which is available to authorized users.

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Author: Oliver HH Gerlach - Martijn PG Broen - Peter HMF van Domburg - Ad J Vermeij - Wim EJ Weber


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