The impact of Parkinson's disease as a comorbid diagnosis

Phillips, Aaron Ratnaker; Genever, Richard W

doi:10.1093/ageing/afr022

Cited by 3 publications

(3 citation statements)

References 7 publications

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“…This could be explained by a lower sensitivity in Parkinson's disease patients for the CCI in comparison with the CPS. 26 Even if we demonstrated that CPS could be used as a determinant risk factor, we still observed a low median CPS of 11. Thus, we think that more accurate comorbidity scores should be validated to characterize this particular population.…”

Section: Discussionmentioning

confidence: 72%

Use of enteral access for continuous delivery of levodopa-carbidopa in patients with advanced Parkinson's disease

Cheron

Devière

Ballarin

et al. 2016

Nutrition Clinique et Métabolisme

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BACKGROUND Continuous delivery to the jejunum of levodopa-carbidopa is a promising therapy in patients with advanced Parkinson's disease, as it reduces motor fluctuation. Percutaneous endoscopic gastrostomy and jejunal tube (PEG-J) placement is a suitable option for this. However, studies focused in PEG-J management are lacking. OBJECTIVES We report our experience regarding this technique, including technical success, adverse events and outcomes, in patients with advanced Parkinson's disease. METHODS Twenty-seven advanced Parkinson's disease patients (17 men, median age: 64 years, median disease duration: 11 years) were included in a retrospective study from June 2007 to April 2015. The median follow-up period was 48 months (1-96). RESULTS No adverse events were noted during and after nasojejunal tube insertion (to assess treatment efficacy). After a good therapeutic response, a PEG-J was placed successfully in all patients. The PEG tube was inserted according to Ponsky's method. The jejunal extension was inserted during the same procedure in all patients. Twelve patients (44%) experienced severe adverse events related to the PEG-J insertion, which occurred after a median follow-up of 15.5 months. Endoscopy was the main treatment modality. Patients who experienced severe adverse events had a higher comorbidity score (p = 0.011) but were not older (p = 0.941) than patients who did not. CONCLUSIONS While all patients responded well to levodopa-carbidopa regarding neurological outcomes, gastro-intestinal severe adverse events were frequent and related to comorbidities. Endoscopic treatment is the cornerstone for management of PEG-J related events. In conclusion, clinicians and endoscopists, as well as patients, should be fully informed of procedure-related adverse events and patients should be followed in centres experienced in their management.

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Section: Discussionmentioning

confidence: 72%

Use of enteral access for continuous delivery of levodopa-carbidopa in patients with advanced Parkinson's disease

Cheron

Devière

Ballarin

et al. 2016

Nutrition Clinique et Métabolisme

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“…The impact of Parkinson´s disease (as a comorbid diagnosis) on the burden of hospitalization due to other causes has led to much discussion about recommending its inclusion in a reviewed Charlson Comorbidity Index [ 7 ]. Due to the aging population, the incidence and prevalence of degenerative conditions, such as PD, have increased in the last decades.…”

Section: Introductionmentioning

confidence: 99%

Measuring the Burden of Hospitalization in Patients with Parkinson´s Disease in Spain

et al. 2016

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IntroductionThis epidemiological survey estimates the hospitalization burden related to Parkinson´s Disease in Spain.MethodsThis observational retrospective survey was performed by reviewing data from the National Surveillance System for Hospital Data, which includes more than 98% of Spanish hospitals. All hospitalizations of patients with Parkinson´s disease that were reported from 1997–2012 were analyzed. Codes were selected using the 9th International Classification of Diseases: ICD-9-CM: 332.0.ResultsA total of 438,513 hospital discharges of patients with Parkinson´s Disease were reported during the study period. The annual hospitalization rate was 64.2 cases per 100,000. The average length of hospital stay was 10 days. The trend for the annual hospitalization rate differed significantly depending on whether Parkinson´s disease was the main cause of hospitalization (n = 23,086, 1.14% annual increase) or was not the main cause of hospitalization (n = 415,427, 15.37% annual increase). The overall case-fatality rate among hospitalized patients was 10%. The case fatality rate among patient´s hospitalized with Parkinson´s disease as the main cause of hospitalization was 2.5%. The hospitalization rate and case-fatality rate significantly increased with age. The primary causes of hospitalization when Parkinson´s disease was not coded as the main cause of hospitalization were as follows: respiratory system diseases (24%), circulatory system diseases (19%), injuries and poisoning, including fractures (12%), diseases of the digestive system (10%) and neoplasms (5%). The annual average cost for National Health Care System was € 120 M, with a mean hospitalization cost of €4,378.ConclusionsParkinson´s disease poses a significant health threat in Spain, particularly in the elderly. While hospitalizations due to Parkinson´s Disease are relatively stable over time, the number of patients presenting with Parkinson´s disease as an important comorbidity has increased dramatically. Medical staff must be specifically trained to treat the particular needs of hospitalized patients suffering from Parkinson´s disease as an important comorbidity.

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“…The same trend was observed using the CCI, without being statistically significant. This could be explained by a lower sensitivity in Parkinson’s disease patients for the CCI in comparison with the CPS 26 . Even if we demonstrated that CPS could be used as a determinant risk factor, we still observed a low median CPS of 11.…”

Section: Discussionmentioning

confidence: 57%

The use of enteral access for continuous delivery of levodopa‐carbidopa in patients with advanced Parkinson’s disease

Cheron¹,

Devière²,

Supiot³

et al. 2017

UEG Journal

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While all patients responded well to levodopa-carbidopa regarding neurological outcomes, gastro-intestinal severe adverse events were frequent and related to comorbidities. Endoscopic treatment is the cornerstone for management of PEG-J related events. In conclusion, clinicians and endoscopists, as well as patients, should be fully informed of procedure-related adverse events and patients should be followed in centres experienced in their management.

show abstract

The impact of Parkinson's disease as a comorbid diagnosis

Cited by 3 publications

References 7 publications

Use of enteral access for continuous delivery of levodopa-carbidopa in patients with advanced Parkinson's disease

Use of enteral access for continuous delivery of levodopa-carbidopa in patients with advanced Parkinson's disease

Measuring the Burden of Hospitalization in Patients with Parkinson´s Disease in Spain

The use of enteral access for continuous delivery of levodopa‐carbidopa in patients with advanced Parkinson’s disease

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