Abstract
Background Parkinson's disease affects approximately 1% of the worldwide population older than 60 years. This number is estimated to double by 2030, increasing the global burden of the disease. Patients with Parkinson's disease are hospitalized 1.5 times more frequently and for longer periods than those without the disease, increasing health-related costs. Objective To compare the characteristics and outcome of patients with and without Parkinson's disease admitted to intensive care units (ICUs). Methods Historical cohort study of ICU admissions in a Brazilian city over 18 years. All patients with Parkinson's disease identified were matched for age, sex, year, and place of hospitalization with patients without the disease randomly selected from the same database. Results The study included 231 patients with Parkinson's disease (PD group) and 462 controls without the disease (NPD group). Compared with patients in the NPD group, those in the PD group were more frequently admitted with lower level of consciousness and increased APACHE II severity score but required less frequently vasoactive drugs. In total, 42.4% of the patients in the PD group were admitted to the ICUs due to sepsis or trauma. Although these patients had longer hospital stay, the mortality rates were comparable between groups. Parkinson's disease was not associated with mortality, even when controlled for associated factors of disease severity. Conclusion Although patients with Parkinson's disease were admitted with higher severity scores and remained in the ICU for a longer time, their mortality rate was not higher than that in patients without the disease.
Highlights
Parkinson’s disease is one of the most prevalent degenerative disorders of the central nervous system [1]
Historical cohort study of patients admitted to intensive care units (ICUs) across seven hospitals in Curitiba (Parana, Brazil). e data were extracted from the database of the Center for Study and Research in Intensive Care (CEPETI), which has been updated since 2000 with all data of patients consecutively admitted to the ICUs. is study was performed in accordance with the Declaration of Helsinki. e study project was approved by the Human Research Ethics Committee of the Neurology Institute of Curitiba (INC)
We collected the following variables: age, sex, source of transfer to the ICU, public or private healthcare, reason for ICU admission, hemodynamic support with vasoactive drugs and invasive ventilatory support on ICU admission, Sequential Organ Failure Assessment (SOFA) and Acute Physiology and Chronic Health Evaluation (APACHE II) scores in the first 24 hours in the ICU, level of consciousness measured by the Glasgow coma score on ICU admission and discharge, level of advanced life support, length of ICU stay, and ICU mortality
Summary
Parkinson’s disease is one of the most prevalent degenerative disorders of the central nervous system [1] It affects approximately 1% of the worldwide population older than 60 years and, added to population aging, imposes a high economic and social burden [2]. Patients with Parkinson’s disease are hospitalized 1.5 times more frequently and for longer periods than those without the disease, increasing health-related costs. 42.4% of the patients in the PD group were admitted to the ICUs due to sepsis or trauma These patients had longer hospital stay, the mortality rates were comparable between groups. Patients with Parkinson’s disease were admitted with higher severity scores and remained in the ICU for a longer time, their mortality rate was not higher than that in patients without the disease
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