scholarly journals Missing Dosages and Neuroleptic Usage May Prolong Length of Stay in Hospitalized Parkinson's Disease Patients

PLoS ONE ◽  
2015 ◽  
Vol 10 (4) ◽  
pp. e0124356 ◽  
Author(s):  
Daniel Martinez-Ramirez ◽  
Juan C. Giugni ◽  
Christopher S. Little ◽  
John P. Chapman ◽  
Bilal Ahmed ◽  
...  
2020 ◽  
Vol 10 (4) ◽  
pp. 1577-1586
Author(s):  
Michelle Fullard ◽  
Dylan Thibault ◽  
Hanan Zisling ◽  
James A. Crispo ◽  
Allison Willis

Background: Advances in the treatment of Parkinson’s disease (PD) have allowed for improvements in mortality and quality survival, making the management of comorbid conditions of aging, such as osteoarthritis, crucial. Objective: To determine the extent to which PD impacts hospitalization outcomes after an elective orthopedic procedure. Methods: This retrospective cohort study used data from the National Readmissions Database and included adults ages 40 and above with and without PD. Primary outcomes included length of stay of the index admission, discharge disposition and 30-day readmission. Logistic regression was used to compare the odds of readmission for PD patients compared to non-PD. Clinical conditions associated with readmission were compared between the two groups. Results: A total of 4,781 subjects with PD and 947,475 subjects without PD met inclusion criteria. Length of stay (LOS) during the index admission was longer for PD patients. PD patients were much more likely to be discharged to inpatient post-acute care (49.3% vs 26.2%) while non-PD subjects were more likely to be discharged home with (31.9% [PD] vs 44.8% [non-PD]) or without home health (18.7% [PD] vs 28.9% [non-PD]). A total of 271 PD patients (5.66%) and 28,079 non-PD patients (2.96%) were readmitted within 30 days following surgery. After adjusting for age, sex, socioeconomic status, expected payer, comorbidities, index admission LOS, year and discharge disposition, PD subjects were 31% more likely to be readmitted than non-PD subjects (AOR 1.31, 1.07–1.62). Conclusions: Parkinson’s disease patients were readmitted more often than non-PD patients, although the rate of readmission was still low.


2020 ◽  
Vol 27 (7) ◽  
pp. 1-6
Author(s):  
Christopher J Lovegrove ◽  
Jonathan Marsden

Background People with Parkinson's disease report that inpatient hospital environments do not replicate their home setup. A therapy pathway was developed integrating early home-based assessment, therapy sessions with photographs of key home areas, enhanced communication with community services, and staggered discharge. Methods Outcome measures (length of stay and readmissions within 14 days) in people with Parkinson's disease on the therapy pathway (n=5) were compared to those previously receiving standard care (n=5). Results Mean length of stay was 7.2 days shorter in the intervention group and their discharge Lindop Parkinson's mobility scale score was 39.4% higher. No difference was found in the Modified Barthel Index between the groups. Both groups had the same readmission rates. The pathway was accepted by both people with Parkinson's disease and clinicians. Conclusions The pathway reduced hospital length of stay and increased mobility in patients with Parkinson's disease. It was accepted by patients and clinicians and was feasible to integrate into current practice. The pathway warrants further evaluation.


SAGE Open ◽  
2018 ◽  
Vol 8 (3) ◽  
pp. 215824401879479
Author(s):  
Tobias Romeyke ◽  
Elisabeth Noehammer ◽  
Hans Christoph Scheuer ◽  
Harald Stummer

2020 ◽  
Vol 3 ◽  
pp. 100076
Author(s):  
Hooman Azmi ◽  
Lisa Cocoziello ◽  
Themba Nyirenda ◽  
Claudia Douglas ◽  
Blessy Jacob ◽  
...  

Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Veronica Moreno Gomez ◽  
Maria Shoaib ◽  
Muhammad Farhan Khaliq ◽  
Chao Xu ◽  
Timothy Copeland ◽  
...  

Introduction: A paucity of studies exists about the influence of Parkinson’s Disease (PD) in the length of stay (LOS) among patients admitted with acute ischemic stroke (AIS). We seek to identify if a prior history of PD impacts the LOS of AIS patients, and to establish the factors associated it. Methodology: We analyzed data of the NIS from the Healthcare Cost and Utilization Project (HCUP) from 1998 to 2017, using a negative binomial regression to assess sociodemographic factors and hospital characteristics associated with LOS in AIS patients with PD. Results: A total of 835,380,672 hospitalizations were identified with discharge diagnosis of AIS. The cohort was divided into 2 groups based on presence of history of PD during the same admission. 12,799,437 of AIS patients had discharge records with a secondary diagnosis of PD. Non-Parkinson’s disease cohort had longer hospital stay (Incidence Rate Ratio IRR 1.02 (95% CI 1.01-1.03). An increased LOS was observed in males compared to females (IRR 1.03 (1.00-1.03)); Black (IRR 1.17 (95% CI 1.16-1.18)), Hispanics (IRR 1.13 (95% CI 1.11-1.14)) and Asians (IRR 1.22 (95% CI 1.19-1.26)) when compared to whites, Medicaid when compared to Medicare (IRR 1.37 (95% CI 1.34-1.41)). Higher Elixhauser index corresponded to longer LOS (IRR 1.14 (CI 1-14-1.14)). In terms of hospital factors, Urban teaching hospital was associated with longer LOS when compared to rural hospital (IRR 1.18 (95% CI 1.16-1.19)), Northeast compared to West region hospital areas (IRR 1.3 (95% CI 1.27-1.33)). Decreasing LOS was seen over the course of last 20 years. Conclusion: Admission for ischemic stroke tended to result in longer length of stay among non-Parkinson’s patients. Patient characteristics are a greater source of variability in length of stay than Parkinson’s disease status.


2018 ◽  
Vol 3 (2) ◽  
pp. 23
Author(s):  
N. M. Enwerem ◽  
P. O. Okunji ◽  
J. S. Ngwa ◽  
S. G. Karavatas ◽  
T. V. Fungwe ◽  
...  

Background: Parkinson's disease (PD) is the second most common neurodegenerative disease, after Alzheimer’s disease, affecting approximately one million persons aged 65 years and above in the United States. Parkinson's disease represents a major medical concern for health professionals, national healthcare bodies and a heavy burden for caregivers. Heart failure occurred twice as frequently in elderly PD patients as in non-PD patients. There is paucity of information on the association of patient and hospital characteristics on the outcomes of inpatient with both congestive heart failure and Parkinson disease.Congestive Heart Failure with PD as a comorbidity will increase the cost of care and health resources. We investigate on the current prevalence and factors that affect the inpatient with both CHF and PD conditions using a longitudinal datasets from National Inpatient Samples. The results obtained from this study will provide information that will reduce frequent readmission, length of stay, total charges and mortality rate in this population.Methods: Data from the National Inpatient Samples (NIS) were extracted and analyzed using ICD 9 codes (CHF 428, PD 332) for the main diagnosis. For continuous variables, we calculated the mean and standard deviations and evaluated significant differences of these factors by Parkinson disease status using the t-test. For categorical variables, we obtained the counts (proportions) and evaluated significant differences using the Chi-square and Fisher’s exact test Propensity score was utilized to match age, gender and race using logistic model for hospital death and generalized linear model for length of stay (LOS) and hospital charges.Result: The overall frequency of Parkinson disease (PD) in congestive heart failure was 1.54 % (n = 10,748). PD patients with CHF were more likely to be males (53.13 %; 5462) and Caucasians (82.24 %; n=8454). The average age of inpatient was approximately 80 years (SD=8.05). Hospital admission, decreases with median household income. Patients with low income ($1 - $38,999) were admitted more with 3002 (29.70%) than those with higher income ($63,000 and more) with 2230 (22.06%). Length of stay (LOS) (p<0.0001) and total charge incurred during hospitalization were less in patients with PD (p< 0.005) (table 1). In these analyses, we found that patients with PD were discharged more from urban non-teaching hospital than urban teaching hospital (p<0.0001).Conclusion: The general characteristics and frequency of the participant in this study are summarized in Table I. Accordingly, characteristics of patients with congestive heart failure with or without Parkinson’s disease did not differ by age, gender, or ethnicity (P>1.000). Similarly, hospital death rates (%) were not different (P>1.000), although hospital length of stay (P<1.000) and total charge incurred during hospitalization were less in patients with PD (p < 0.005)


2021 ◽  
pp. 1-7
Author(s):  
Daniel G. Di Luca ◽  
Eric W. McArthur ◽  
Allison Willis ◽  
Rosemary Martino ◽  
Connie Marras

Background: Dysphagia is a frequent complication that may increase morbidity and mortality in Parkinson’s disease (PD). Nevertheless, there is limited data on its objective impact on healthcare outcomes. Objective: To investigate the outcomes associated with dysphagia in hospitalized patients with PD and associated healthcare costs and utilization. Methods: We performed a retrospective cohort study using the National Inpatient Sample (NIS) data from 2004 to 2014. A multivariable regression analysis was adjusted for demographic, and comorbidity variables to examine the association between dysphagia and associated outcomes. Logistic and negative binomial regressions were used to estimate odds or incidence rate ratios for binary and continuous outcomes, respectively. Results: We identified 334,395 non-elective hospitalizations of individuals with PD, being 21,288 (6.36%) associated with dysphagia. Patients with dysphagia had significantly higher odds of negative outcomes, including aspiration pneumonia (AOR 7.55, 95%CI 7.29–7.82), sepsis (AOR 1.91, 95%CI 1.82–2.01), and mechanical ventilation (AOR 2.00, 95%CI 1.86–2.15). For hospitalizations with a dysphagia code, the length of stay was 44%(95%CI 1.43–1.45) longer and inpatient costs 46%higher (95%CI 1.44–1.47) compared to those without dysphagia. Mortality was also substantially increased in individuals with PD and dysphagia (AOR 1.37, 95%CI 1.29–1.46). Conclusion: In hospitalized patients with PD, dysphagia was a strong predictor of adverse clinical outcomes, and associated with substantially prolonged length of stay, higher mortality, and care costs. These results highlight the need for interventions focused on early recognition and prevention of dysphagia to avoid complications and lower costs in PD patients.


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