Pattern of hospital admission and outcome in Parkinson’s disease: A study from Punjab, India

ABSTRACT

Background: The hospitalization rates of patients with Parkinson’s disease (PD) are 1.45 times higher than for age matched controls. We studied the causes for admission, hospital course and outcomes in PD population so that preventive measures could be developed. Methods: We prospectively studied patients with the diagnosis of PD admitted to a tertiary care hospital in Ludhiana, India from January, 2012 to December, 2014. Etiology for hospitalization was determined and the patients were divided into two groups, admission due to causes related to PD or not associated with PD. The PD related admissions were further categorized into Group I directly disease related causes and Group II indirectly disease related causes. The primary outcome was mortality. The secondary outcome measures were duration of hospitalization, requirement for ICU, need for mechanical ventilation and complications. Results: There were 146 patients of PD out of 25,326 hospital admissions. Forty two patients (28.7%) had direct cause, 73(50%) had indirect cause and 31(21.2%) were non-PD related admissions. The mean age was 68.5+9.9 years, 97males (66.7%). There were 16(10.9%) deaths. The commonest cause of admission was infections and encephalopathy. The indirect PD related admission had significantly higher age (p= 0.0014), increased risk of ICU admission (p=0.011), need for mechanical ventilation (p < 0.005) and longer duration of hospital stay (p=0.0001) as compared to group I. Also there was a six fold increased risk of death in this group (p 0.034). Conclusion: As disease progresses, the indirect reasons for admission becomes more troublesome than the initial motor complaints.