Objective: Profile patients with Parkinson’s who experience inpatient care. Assess the impact of admissions to hospital and evaluate readmissions and mortality rates.

Background: People with Parkinson’s (PwP) are more likely to have unscheduled admissions to hospital, tend to have longer hospital stays and experience higher inpatient mortality. There is a scarcity of data relating to hospital admissions and subsequent impact on mortality in this frail cohort of patients.

Methods: We conducted an 18 month follow-up of People with Parkinson’s (PwP) following an acute admission to hospital to audit their routine care. PwP, admitted within a 2 month period between December 2013 and January 2014, were followed-up over the following 18 months. Clinical notes, prescription charts and electronic health records were accessed. Reason for admission, frailty scores, co-morbidities, length of stay, re-admissions within one month of discharge and deaths were recorded.

Results: A total of 41 patients (mean age 78) were studied (29 males, 13 females). Mean readmissions 1.24 (male 1.1, female 1.58, dead 1.4). 12 individuals (28%) were readmitted within a month of discharge. 15 (37%) patients died within a 18 months of the audited admission. The mean age of PwP who died was 80 of whom 11 were male, 4 female. Average frailty index 6 (compared to 4.84 for survivors). Mean admission Charlson Co-morbidity Index score of the non-survivors was 7.47 (compared with 5.53 for survivors). In the year before death the mean number of admissions was 3.61 compared to 1.15 for those who remain alive. For patients readmitted twice or more in the 18 months following index admission, the relative risk of death was 1.4.

Conclusions: PwP being admitted to hospital have a high rate of re-admissions and death within a year of the index event. They can be identified by their higher frailty scores and co-morbidity rates. There appears to be an escalating pattern of admissions in the year preceding death. These features can be used to highlight and proactively plan end of life care.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/can-hospital-admissions-predict-mortality-in-parkinsons/