The association of comorbidity with Parkinson's disease-related hospitalizations

Adrianus L A J Hommel; Jesse H Krijthe; Sirwan Darweesh; Bastiaan R Bloem

doi:10.1016/j.parkreldis.2022.10.012

The association of comorbidity with Parkinson's disease-related hospitalizations

Parkinsonism Relat Disord. 2022 Nov:104:123-128. doi: 10.1016/j.parkreldis.2022.10.012. Epub 2022 Oct 19.

Authors

Adrianus L A J Hommel¹, Jesse H Krijthe², Sirwan Darweesh³, Bastiaan R Bloem⁴

Affiliations

¹ Primary and Community Care, Radboud University Medical Center, Nijmegen, the Netherlands; Groenhuysen Organisation, Roosendaal, the Netherlands.
² Delft University of Technology, Pattern Recognition & Bioinformatics, Delft, the Netherlands.
³ Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, the Netherlands.
⁴ Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, the Netherlands. Electronic address: Bas.Bloem@radboudumc.nl.

PMID: 36333237
DOI: 10.1016/j.parkreldis.2022.10.012

Abstract

Introduction: Unplanned hospital admissions associated with Parkinson's disease could be partly attributable to comorbidities.

Methods: We studied nationwide claims databases and registries. Persons with newly diagnosed Parkinson's disease were identified based on the first Parkinson's disease-related reimbursement claim by a medical specialist. Comorbidities were classified based on the Charlson Comorbidity Index. We studied hospitalization admissions because of falls, psychiatric diseases, pneumonia and urinary tract infections, PD-related hospitalizations-not otherwise specified. The association between comorbidities and time-to-hospitalization was estimated using Cox proportional hazard modelling. To better understand pathways leading to hospitalizations, we performed multiple analyses on causes for hospitalizations.

Results: We identified 18 586 people with newly diagnosed Parkinson's disease. The hazard of hospitalization was increased in persons with peptic ulcer disease (HR 2.20, p = 0.009), chronic obstructive pulmonary disease (HR 1.61, p < 0.001), stroke (HR 1.37, p = 0.002) and peripheral vascular disease (HR 1.31, p = 0.02). In the secondary analyses, the hazard of PD-related hospitalizations-not otherwise specified (HR 3.24, p = 0.02) and pneumonia-related hospitalization (HR 2.90, p = 0.03) was increased for those with comorbid peptic ulcer disease. The hazard of fall-related hospitalization (HR 1.57, p = 0.003) and pneumonia-related hospitalization (HR 2.91, p < 0.001) was increased in persons with chronic obstructive pulmonary disease. The hazard of pneumonia-related hospitalization was increased in those with stroke (HR 1.54, p = 0.03) or peripheral vascular disease (HR 1.60, p = 0.02). The population attributable risk of comorbidity was 8.4%.

Conclusion: Several comorbidities increase the risk of Parkinson's disease related-hospitalization indicating a need for intervention strategies targeting these comorbid disorders.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Comorbidity
Hospitalization
Humans
Parkinson Disease* / complications
Parkinson Disease* / epidemiology
Peptic Ulcer*
Peripheral Vascular Diseases* / complications
Peripheral Vascular Diseases* / epidemiology
Pneumonia* / complications
Pneumonia* / epidemiology
Pulmonary Disease, Chronic Obstructive* / complications
Pulmonary Disease, Chronic Obstructive* / epidemiology
Retrospective Studies
Stroke* / complications