High rates and the risk factors for emergency room visits and hospitalization in Parkinson's disease

Parkinsonism Relat Disord. 2013 Nov;19(11):949-54. doi: 10.1016/j.parkreldis.2013.06.006. Epub 2013 Jul 5.


Background: Parkinson's disease (PD) patients are hospitalized more frequently than their peers as a result of falls, psychosis, infections and other medical complications. However, patient-specific risk factors for hospitalization are unclear.

Objective: To identify rates and risk factors for hospital encounters (Emergency Room [ER] visits or hospitalization) among people with PD.

Methods: 3415 PD participants (mean age 67 ± 10 years, disease duration 9 ± 6 years, H&Y 2 47%, H&Y 3 26%) enrolled in the prospective international multicenter NPF-QII Study. One-year follow-up data was available for 1030 patients. Rates and risk factors for hospital encounters were determined at baseline and after one year follow-up.

Results: Of 3415 PD participants at study entry, 1120 (33%) reported at least one hospital encounter. Associations were: longer timed up-and-go test (OR: 1.33), increased comorbidities (OR: 1.25), motor fluctuations (OR: 1.32), and deep brain stimulation (DBS) (OR: 2.49). Of these 1120 persons, 311 had follow-up data and 158 (51%) had a repeat encounter one year later, associated with higher H&Y stage, fluctuations, and lower health-related quality-of-life. Of 2295 participants without a hospital encounter at baseline, 719 had follow-up data and 178 (25%) had a first hospital encounter one year later. Risk factors were female gender, comorbidities, lower cognition, fluctuations, and DBS.

Conclusions: One-third of people with PD had a hospital encounter each year, and one-half of those had a repeat encounter. These high rates correlated with disease severity, comorbidities and DBS. There is an urgent need to develop programs to reduce PD hospital encounters.

Keywords: Admissions; Comorbidities; Emergency care; Hospitalization; Parkinson's disease.

Publication types

  • Multicenter Study

MeSH terms

  • Aged
  • Emergency Service, Hospital / economics
  • Emergency Service, Hospital / trends*
  • Female
  • Follow-Up Studies
  • Hospitalization / economics
  • Hospitalization / trends*
  • Humans
  • Internationality
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Parkinson Disease / economics
  • Parkinson Disease / epidemiology*
  • Parkinson Disease / therapy*
  • Prospective Studies
  • Risk Factors