Falls Predict Acute Hospitalization in Parkinson's Disease

跌倒可预测帕金森病患者急性住院

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作者:Diego Santos García, Teresa de Deus Fonticoba, Carlos Cores, Ester Suárez Castro, Jorge Hernández Vara, Silvia Jesús, Pablo Mir, Marina Cosgaya, Maria José Martí, Pau Pastor, Iria Cabo, Manuel Seijo, Inés Legarda, Bárbara Vives, Nuria Caballol, Javier Rúiz Martínez, Ioana Croitoru, Esther Cubo, Javi

Background

There is a need for identifying risk factors for hospitalization in Parkinson's disease (PD) and also interventions to reduce acute hospital admission.

Conclusion

Falls is an independent predictor of AH in PD patients.

Methods

PD patients recruited from 35 centers of Spain from the COPPADIS-2015 (COhort of Patients with PArkinson's DIsease in Spain, 2015) cohort from January 2016 to November 2017, were included in the study. In order to identify predictors of AH, Kaplan-Meier estimates of factors considered as potential predictors were obtained and Cox regression performed on time to hospital encounter 1-year after the baseline visit.

Objective

To analyze the frequency, causes, and predictors of acute hospitalization (AH) in PD patients from a Spanish cohort.

Results

Thirty-five out of 605 (5.8%) PD patients (62.5±8.9 years old; 59.8% males) presented an AH during the 1-year follow-up after the baseline visit. Traumatic falls represented the most frequent cause of admission, being 23.7% of all acute hospitalizations. To suffer from motor fluctuations (HR [hazard ratio] 2.461; 95% CI, 1.065-5.678; p = 0.035), a very severe non-motor symptoms burden (HR [hazard ratio] 2.828; 95% CI, 1.319-6.063; p = 0.008), falls (HR 3.966; 95% CI 1.757-8.470; p = 0.001), and dysphagia (HR 2.356; 95% CI 1.124-4.941; p = 0.023) was associated with AH after adjustment to age, gender, disease duration, levodopa equivalent daily dose, total number of non-antiparkinsonian drugs, and UPDRS-IIIOFF. Of the previous variables, only falls (HR 2.998; 95% CI 1.080-8.322; p = 0.035) was an independent predictor of AH.

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