Objective: To investigate the status after the emergency admissions and to determine the cause and location of death in patients with Parkinson disease (PD).

Background: We have identified few studies that have investigated the prognosis and end-of-life status of PD patients after emergency admissions. Furthermore, little is known about the cause and location of death in the late stage of Japanese PD patients.

Methods: A single center retrospective study. Subjects were identified from discharge records listing primary or secondary diagnoses of PD [International classification of disease-10-CM G20] from the administrative inpatient data set of our university hospital from January 2013 to September 2015. The patients’ status after discharges from our hospital were retrospectively investigated at December 2016.

Results: The total number of inpatients exposed to analysis was 150 (age; 71 ± 10 years old; mean ± SD). The age of patients emergently admitted (n=67) was significantly older and the Hoehn and Yahr Staging Scale (H&Y) of subjects urgently admitted was significantly more severe than those of patients with planned admissions (n=83) (p<0.01 and p<0.01, respectively). After emergency admissions, there was 50% reduction in those who returned to their own home. The most common reasons for emergency admission that then required to transfer to nursing homes or community hospitals were pulmonary infection (16/40, 25%), followed by fractures, PD-related motor and/or nonmotor problems, gastrointestinal problems, urinary tract infection and others. For decedents with PD (n=13), mean age at death was 79 ± 6 years old and the most common associated cause of death was pneumonia (n=8), followed by gastrointestinal diseases (n=2), cardiovascular disease (n=2) and infection excluding pneumonia (n=1). All decedents with PD died in hospitals. The present locations of living patients after transfers (n=27) were as follows: their own home (n=14), nursing home (n=9), community hospital (n=2) and unknown (n=2).

Conclusions: We revealed that there was an increase in discharge to community hospital or nursing home care after the emergency admission. After transfers, all decedents with PD did not die at home in our study. The complications of PD, especially respiratory infection, were commonly recorded as the associated cause of death.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/prognosis-and-end-of-life-status-after-emergency-admissions-in-patients-with-parkinson-disease-a-japanese-single-center-retrospective-study/