Objective: To undertake a scoping review examining what outcomes are measured for patients with Parkinson’s Disease (PwP) undergoing non-Parkinson’s Disease (PD) specific surgery. To summarise existing strategies to improve outcomes for PwP during the perioperative period.

Background: Many PwP will undergo surgery. This surgery may be related directly to their PD diagnosis (e.g. deep brain stimulation), to complications of PD (e.g. trauma after falls) or for unrelated pathology. Surgical management is increasingly an option for treatment comorbidities, improving longevity, managing symptoms and retaining quality of life. However, PwP require careful anaesthetic considerations and appear to be at increased risk of perioperative complications including longer hospital stays, higher rates of postoperative delirium and poorer surgical outcomes.

Method: A scoping review was undertaken using MEDLINE, Embase, Cochrane CENTRAL and CINAHL. Inclusion criteria were articles on perioperative outcomes or interventions to improve perioperative outcomes for PwP across all surgical specialties. Studies focused solely on Parkinson’s Disease specific surgery such as deep brain stimulation were excluded.

Results: 78 articles were identified. Most studies were retrospective cohorts (n=30). The most common surgical specialities were orthopaedics (n=70) and neurosurgery (n=16). A variety of outcomes were measured across the studies including: complications (n=78), length of stay (n=29), mortality (n=19), quality of life (n=15), readmission (n=13), discharge to care (n=10) ITU stays (n=1), change in MDS-UPDRS (n=1). No studies measured advanced care planning or an intervention to improve perioperative outcomes for PwP.

Conclusion: PwP are a heterogeneous patient population undergoing a diverse range of surgical interventions. Within this is a high risk surgical group, with opportunity for triage, optimisation and intervention during the perioperative pathway to improve outcomes. Future high quality large-scale studies across the spectrum of surgical specialties using outcomes important for PwP to make informed decisions around their surgical care are required.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/perioperative-outcomes-for-patients-with-parkinsons-disease-a-scoping-review/