Evaluating Outcomes for Older Patients with Parkinson's Disease or Dementia with Lewy Bodies who have been Hospitalised for Hip Fracture Surgery: Potential Impact of Drug Administration.

Abstract

People with Parkinson's disease (PD) are at risk of falling and have an increased risk of complications and prolonged recovery during hospitalisation. The aim of this study was to investigate the rate of complications and recovery related to a hip fracture in patients with PD. All patients with PD or dementia with Lewy bodies (DLB) and a hip fracture who were admitted from January 2013 through June 2014 (18months) to the Department of Orthopaedics, Copenhagen University Hospital, Herlev, Denmark were evaluated. Data regarding duration of admission, complications, timing of administration of anti-PD medication, and level of mobility at discharge were obtained from files of patients with PD or DLB and compared with data from a comparable group of patients who were admitted with a hip fracture and chronic obstructive pulmonary disease (COPD). A total of 31 patients with PD or DLB (PD/DLB group) and 45 patients with COPD (COPD group) were registered during the timeframe investigated. The patients in the PD/DLB group were significantly (p<0.05) younger than those in the COPD group (77.7 vs. 80.7years, respectively) and had lower co-morbidity scores (0.9 vs 2.6, respectively). There were no significant differences in length of stay, delirium, or number of infections between the groups. Two thirds of patients with PD were not able to walk unassisted at discharge. Less than 50% of anti-PD medication was given within ±1h of the scheduled time. Although patients with PD/DLB are significantly younger and have significantly lower degrees of co-morbidity than patients with COPD, their course and recovery after surgery are equivalent to those of patients with COPD. Patients with PD/DLB are at high risk of developing complications during hospital admission for hip fracture.