Mortality of advanced Parkinson's disease patients treated with deep brain stimulation surgery

Abstract

ObjectiveDespite the widespread use of deep brain stimulation (DBS) for patients with Parkinson's disease (PD), long-term outcomes remain unclear. We aimed to analyze the mortality of advanced PD patients who received DBS surgery. MethodsWe assessed the survival rate of 158 consecutive advanced PD patients who underwent DBS surgery between April 2002 and May 2014. Kaplan-Meier survival curves were constructed using death as the endpoint. Cox proportional hazards regression models were used to assess the association of clinical risk factors with survival. ResultsTwenty-seven (17.1%) PD patients (13 men and 14 women) died during the mean follow-up period of 5.3±3.1years. The survival rate was 97% at 3years and 85% at 5years after DBS surgery. Pneumonia (n=7) was the most common specific cause of death. Orthostatic hypotension was more frequent in deceased patients than in survivors (P=0.026). In a step-wise Cox regression analysis, male sex (hazard ratio (HR)=3.00; 95% confidence interval (CI)=1.35–6.65; P=0.007), visual hallucination (HR=3.95; 95% CI=1.60–9.78; P=0.003), and nursing home admission (HR=2.81; 95% CI=1.30–6.09; P=0.009) predicted poor survival. ConclusionThe poor survival of advanced PD patients who underwent DBS surgery was associated with male sex, orthostatic hypotension, visual hallucination, and nursing home admission.