Falls Predict Acute Hospitalization in Parkinson’s Disease

Article type: Research Article

Authors: Santos García, Diego^{a; *} | de Deus Fonticoba, Teresa^b | Cores, Carlos^a | Castro, Ester Suárez^b | Hernández Vara, Jorge^c | Jesús, Silvia^{d; e} | Mir, Pablo^{d; e} | Cosgaya, Marina^f | Martí, Maria José^f | Pastor, Pau^g | Cabo, Iria^h | Seijo, Manuel^h | Legarda, Inésⁱ | Vives, Bárbaraⁱ | Caballol, Nuria^j | Rúiz Martínez, Javier^k | Croitoru, Ioana^k | Cubo, Esther^l | Miranda, Javier^l | Alonso Losada, Maria Gema^m | Labandeira, Carmen^m | López Ariztegui, Nuriaⁿ | Morales-Casado, Mabelⁿ | González Aramburu, Isabel^o | Infante, Jon^o | Escalante, Sonia^p | Bernardo, Noemí^p | Blázquez Estrada, Marta^q | Menéndez González, Manuel^g | Caldentey, Juan García^r | Borrué, Carmen^s | Vela, Lydia^t | Catalán, Maria José^u | Gómez Mayordomo, Víctor^u | Kurtis, Mónica^v | Prieto, Cristina^w | Ordás, Carlos^w | Nogueira, Víctor^x | López Manzanares, Lydia^y | Ávila Rivera, Maria Asunción^z | Puente, Victor^aa | García Moreno, Jose Manuel^bb | Solano Vila, Berta^cc | Álvarez Sauco, María^dd | Carrillo Padilla, Francisco^ee | Carlos Martínez Castrillo, Juan^ff | Sánchez Alonso, Pilar^gg | Gastón, Itziar^hh | Kulisevsky, Jaime^{e; ii} | Valero, Caridad^jj | de Fábregues, Oriol^c | González Ardura, Jessica^kk | López Díaz, Luis Manuel^ll | Martinez-Martin, Pablo^e | COPPADIS Study Group

Affiliations: [a] CHUAC, Complejo Hospitalario Universitario de A Coruña, A Coruña, Spain | [b] CHUF, Complejo Hospitalario Universitario de Ferrol, A Coruña, Spain | [c] Neurology Department and Neurodegenerative Diseases Research. Vall D’Hebron Universitary Campus, Barcelona, Spain | [d] Unidad de Trastornos del Movimiento, Servicio de Neurología y Neurofisiología Clínica, Instituto de Biomedicina de Sevilla, Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Seville, Spain | [e] CIBERNED (Centro de Investigación Biomédica en Red Enfermedades Neurodegenerativas), Spain | [f] Hospital Clínic de Barcelona, Barcelona, Spain | [g] Movement disorders Unit, University Hospital Mutua de Terrassa, Barcelona, Spain | [h] Complejo Hospitalario Universitario de Pontevedra (CHOP), Pontevedra, Spain | [i] Hospital Universitario Son Espases, Palma de Mallorca, Spain | [j] Consorci Sanitari Integral, Hospital Moisés Broggi, Sant Joan Despí, Barcelona, Spain | [k] Hospital Universitario Donostia, San Sebastián, Spain | [l] Complejo Asistencial Universitario de Burgos, Burgos, Spain | [m] Hospital Álvaro Cunqueiro, Complejo Hospitalario Universitario de Vigo (CHUVI), Vigo, Spain | [n] Complejo Hospitalario de Toledo, Toledo, Spain | [o] Hospital Universitario Marqués de Valdecilla, Santander, Spain | [p] Hospital de Tortosa Verge de la Cinta (HTVC), Tortosa, Tarragona, Spain | [q] Hospital Universitario Central de Asturias, Oviedo, Spain | [r] Centro Neurológico Oms, Palma de Mallorca, Spain | [s] Hospital Infanta Sofía, Madrid, Spain | [t] Fundación Hospital de Alcorcón, Madrid, Spain | [u] Hospital Universitario Clínico San Carlos, Madrid, Spain | [v] Hospital Ruber Internacional, Madrid, Spain | [w] Hospital Rey Juan Carlos, Madrid, Spain | [x] Hospital Da Costa, Burela, Lugo, Spain | [y] Hospital Universitario La Princesa, Madrid, Spain | [z] Consorci Sanitari Integral, Hospital General de L’Hospitalet, L’Hospitalet de Llobregat, Barcelona, Spain | [aa] Hospital del Mar, Barcelona, Spain | [bb] Hospital Universitario Virgen Macarena, Sevilla, Spain | [cc] Institut d’Assistència Sanitària (IAS) - Institut Català de la Salut. Girona, Spain | [dd] Hospital General Universitario de Elche, Elche, Spain | [ee] Hospital Universitario de Canarias, San Cristóbal de la Laguna, Santa Cruz de Tenerife, Spain | [ff] Hospital Universitario Ramón y Cajal, Madrid, Spain | [gg] Hospital Universitario Puerta de Hierro, Madrid, Spain | [hh] Complejo Hospitalario de Navarra, Pamplona, Spain | [ii] Hospital de Sant Pau, Barcelona, Spain | [jj] Hospital Arnau de Vilanova, Valencia, Spain | [kk] Hospital Universitario Lucus Augusti (HULA), Lugo, Spain | [ll] Complejo Hospitalario Universitario de Orense (CHUO), Orense, Spain

Correspondence: [*] Correspondence to: Dr. Diego Santos García, Department of Neurology, Hospital Universitario de A Coruña (HUAC), Complejo Hospitalario Universitario de A Coruña (CHUAC), C/ As Xubias 84, 15006, A Coruña, Spain. Tel.: +34 646173341; E-mail: [email protected].

Abstract: Background:There is a need for identifying risk factors for hospitalization in Parkinson’s disease (PD) and also interventions to reduce acute hospital admission. Objective:To analyze the frequency, causes, and predictors of acute hospitalization (AH) in PD patients from a Spanish cohort. Methods:PD patients recruited from 35 centers of Spain from the COPPADIS-2015 (COhort of Patients with PArkinson’s DIsease in Spain, 2015) cohort from January 2016 to November 2017, were included in the study. In order to identify predictors of AH, Kaplan-Meier estimates of factors considered as potential predictors were obtained and Cox regression performed on time to hospital encounter 1-year after the baseline visit. Results:Thirty-five out of 605 (5.8%) PD patients (62.5±8.9 years old; 59.8% males) presented an AH during the 1-year follow-up after the baseline visit. Traumatic falls represented the most frequent cause of admission, being 23.7% of all acute hospitalizations. To suffer from motor fluctuations (HR [hazard ratio] 2.461; 95% CI, 1.065–5.678; p = 0.035), a very severe non-motor symptoms burden (HR [hazard ratio] 2.828; 95% CI, 1.319–6.063; p = 0.008), falls (HR 3.966; 95% CI 1.757–8.470; p = 0.001), and dysphagia (HR 2.356; 95% CI 1.124–4.941; p = 0.023) was associated with AH after adjustment to age, gender, disease duration, levodopa equivalent daily dose, total number of non-antiparkinsonian drugs, and UPDRS-IIIOFF. Of the previous variables, only falls (HR 2.998; 95% CI 1.080–8.322; p = 0.035) was an independent predictor of AH. Conclusion:Falls is an independent predictor of AH in PD patients.

DOI: 10.3233/JPD-212539

Journal: Journal of Parkinson's Disease, vol. Pre-press, no. Pre-press, pp. 1-20, 2021