Abstract

Patients with Parkinson disease (PD) were known to have increased risk of complications during hospitalization. The purpose of this study is to validate the global features of postoperative adverse outcomes for patients with PD. Using reimbursement claims fromTaiwan's NationalHealth Insurance Research Database, we conducted a nationwide retrospective cohort study of 6455 patientswith preoperative PD receivingmajor surgery during 2008 to 2012. With a propensity score matching procedure, 12,910 surgical patients without PD were selected for comparison. The adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for 9 major postoperative complications and 30-day postoperative mortality associated with preoperative PD were calculated in the multivariate logistic regressions. Patients with PD had increased risk of postoperative pulmonary embolism (OR 2.72, 95% CI 1.45-5.10), stroke (OR 1.77, 95% CI 1.53-2.05), pneumonia (OR 1.98, 95% CI 1.70-2.31), urinary tract infection (OR 1.52, 95% CI 1.35-1.70), septicemia (OR 1.54, 95% CI 1.37-1.73), acute renal failure (OR 1.36, 95% CI 1.07-1.73), and mortality (OR 1.45, 95% CI 1.06-1.98). The association between preoperative PD and postoperative adverse events was significant in both sexes and every age group. Low income, ≥65 years of age, surgery not in medical center, highest quartile of PD medication users, and more medical conditions worsen the risk of postoperative adverse events in patients with PD. This study showed increased postoperative complications and mortality in patients with PD. Our findings suggest that revision of postoperative care protocols for this population is urgently needed.

Original languageEnglish
Article numbere3196
JournalMedicine (United States)
Volume95
Issue number12
DOIs
Publication statusPublished - 2016

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Parkinson Disease
Cohort Studies
Odds Ratio
Confidence Intervals
Mortality
Propensity Score
Postoperative Care
Insurance
Pulmonary Embolism
Acute Kidney Injury
Urinary Tract Infections
Sepsis
Pneumonia
Hospitalization
Retrospective Studies
Age Groups
Logistic Models
Stroke
Databases
Research

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Outcomes after non-neurological surgery in patients with Parkinson's disease a nationwide matched cohort study. / Huang, Yu Feng; Chou, Yi Chun; Yeh, Chun Chieh; Hu, Chaur-Jong; Cherng, Yih-Giun; Chen, Ta-Liang; Liao, Chien-Chang.

In: Medicine (United States), Vol. 95, No. 12, e3196, 2016.

Research output: Contribution to journalArticle

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abstract = "Patients with Parkinson disease (PD) were known to have increased risk of complications during hospitalization. The purpose of this study is to validate the global features of postoperative adverse outcomes for patients with PD. Using reimbursement claims fromTaiwan's NationalHealth Insurance Research Database, we conducted a nationwide retrospective cohort study of 6455 patientswith preoperative PD receivingmajor surgery during 2008 to 2012. With a propensity score matching procedure, 12,910 surgical patients without PD were selected for comparison. The adjusted odds ratios (ORs) and 95{\%} confidence intervals (CIs) for 9 major postoperative complications and 30-day postoperative mortality associated with preoperative PD were calculated in the multivariate logistic regressions. Patients with PD had increased risk of postoperative pulmonary embolism (OR 2.72, 95{\%} CI 1.45-5.10), stroke (OR 1.77, 95{\%} CI 1.53-2.05), pneumonia (OR 1.98, 95{\%} CI 1.70-2.31), urinary tract infection (OR 1.52, 95{\%} CI 1.35-1.70), septicemia (OR 1.54, 95{\%} CI 1.37-1.73), acute renal failure (OR 1.36, 95{\%} CI 1.07-1.73), and mortality (OR 1.45, 95{\%} CI 1.06-1.98). The association between preoperative PD and postoperative adverse events was significant in both sexes and every age group. Low income, ≥65 years of age, surgery not in medical center, highest quartile of PD medication users, and more medical conditions worsen the risk of postoperative adverse events in patients with PD. This study showed increased postoperative complications and mortality in patients with PD. Our findings suggest that revision of postoperative care protocols for this population is urgently needed.",
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