Searching for just a few words should be enough to get started. If you need to make more complex queries, use the tips below to guide you.
Article type: Research Article
Authors: Di Luca, Daniel G.a; * | McArthur, Eric W.b | Willis, Allisonc | Martino, Rosemaryd; e; f; g | Marras, Conniea; d
Affiliations: [a] Morton and Gloria Shulman Movement Disorders Centre and the Edmond J. Safra Program in Parkinson’s Disease Research, Toronto Western Hospital and University of Toronto, Toronto, ON, Canada | [b] London Health Sciences Centre, London, ON, Canada | [c] Departments of Neurology and Biostatistics, Epidemiology and Informatics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA | [d] Krembil Research Institute, University Health Network, Toronto, ON, Canada | [e] Department of Speech Language Pathology, University of Toronto, Toronto, ON, Canada | [f] Rehabilitation Science Institute, University of Toronto, Toronto, ON, Canada | [g] Department of Otolaryngology- Head and Neck Surgery, University of Toronto, Toronto, ON, Canada
Correspondence: [*] Correspondence to: Daniel G. Di Luca, MD, Movement Disorders Clinic, Toronto Western Hospital, Division of Neurology, Department of Medicine, University of Toronto, Ontario, Canada, 399 Bathurst Street, McL 7-412, Toronto, Ontario M5T 2S8, Canada. E-mail: [email protected].
Abstract: Background:Dysphagia is a frequent complication that may increase morbidity and mortality in Parkinson’s disease (PD). Nevertheless, there is limited data on its objective impact on healthcare outcomes. Objective:To investigate the outcomes associated with dysphagia in hospitalized patients with PD and associated healthcare costs and utilization. Methods:We performed a retrospective cohort study using the National Inpatient Sample (NIS) data from 2004 to 2014. A multivariable regression analysis was adjusted for demographic, and comorbidity variables to examine the association between dysphagia and associated outcomes. Logistic and negative binomial regressions were used to estimate odds or incidence rate ratios for binary and continuous outcomes, respectively. Results:We identified 334,395 non-elective hospitalizations of individuals with PD, being 21,288 (6.36%) associated with dysphagia. Patients with dysphagia had significantly higher odds of negative outcomes, including aspiration pneumonia (AOR 7.55, 95%CI 7.29–7.82), sepsis (AOR 1.91, 95%CI 1.82–2.01), and mechanical ventilation (AOR 2.00, 95%CI 1.86–2.15). For hospitalizations with a dysphagia code, the length of stay was 44%(95%CI 1.43–1.45) longer and inpatient costs 46%higher (95%CI 1.44–1.47) compared to those without dysphagia. Mortality was also substantially increased in individuals with PD and dysphagia (AOR 1.37, 95%CI 1.29–1.46). Conclusion:In hospitalized patients with PD, dysphagia was a strong predictor of adverse clinical outcomes, and associated with substantially prolonged length of stay, higher mortality, and care costs. These results highlight the need for interventions focused on early recognition and prevention of dysphagia to avoid complications and lower costs in PD patients.
Keywords: Dysphagia, Parkinson’s disease, neurodegenerative diseases, healthcare costs
DOI: 10.3233/JPD-212798
Journal: Journal of Parkinson's Disease, vol. 11, no. 4, pp. 1965-1971, 2021
IOS Press, Inc.
6751 Tepper Drive
Clifton, VA 20124
USA
Tel: +1 703 830 6300
Fax: +1 703 830 2300
[email protected]
For editorial issues, like the status of your submitted paper or proposals, write to [email protected]
IOS Press
Nieuwe Hemweg 6B
1013 BG Amsterdam
The Netherlands
Tel: +31 20 688 3355
Fax: +31 20 687 0091
[email protected]
For editorial issues, permissions, book requests, submissions and proceedings, contact the Amsterdam office [email protected]
Inspirees International (China Office)
Ciyunsi Beili 207(CapitaLand), Bld 1, 7-901
100025, Beijing
China
Free service line: 400 661 8717
Fax: +86 10 8446 7947
[email protected]
For editorial issues, like the status of your submitted paper or proposals, write to [email protected]
如果您在出版方面需要帮助或有任何建, 件至: [email protected]