Young-onset Parkinson's disease: hospital utilization and medical comorbidity in a nationwide survey.
OBJECTIVE
10% of Parkinson's disease (PD) patients have young-onset PD (YOPD). We compared YOPD patients to control patients in terms of hospital utilization and outcomes and medical comorbidities during hospitalization.


METHODS
The Nationwide Inpatient Sample (NIS) provides yearly data on hospital admissions and discharges from approximately 1,000 hospitals. NIS data sets (1998-2003) were used to identify persons aged 18-40 years, including 714 PD patients and 2,007 randomly selected control patients (1:3 matching).


RESULTS
Hospital length of stay (p < 0.001) and number of discharge diagnoses (p < 0.001) were higher in PD patients than controls. PD patients were more likely than controls to be discharged to a short-term hospital (odds ratio, OR, 2.23, 95% confidence interval, CI, 1.30-3.84, p = 0.004) or a skilled nursing facility (OR 4.14, 95% CI 3.06-5.61, p < 0.001); 20.4% required transfer to a short-term hospital or another facility. The most common discharge Diagnosis-Related Group code in PD patients was psychosis (23% of patients) whereas pneumonia and hip or pelvic fractures were not associated with PD.


CONCLUSIONS
YOPD patients had greater healthcare utilization and hospital morbidity than controls. Upon discharge, 1 in 5 required transfer to a short-term hospital or another facility. Psychosis was the most common comorbidity whereas several comorbidities associated with older PD patients were not common.
Louis
Elan D
ED
GH Sergievsky Center, New York, NY, USA. edl2@columbia.edu
Henchcliffe
Claire
C
Bateman
Brian T
BT
Schumacher
Christian
C
D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D016022:Case-Control Studies; D003953:Diagnosis-Related Groups; D005260:Female; D019538:Health Care Surveys; D006304:Health Status; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D010300:Parkinson Disease / Q000150:complications* / Q000453:epidemiology* / Q000628:therapy; D016896:Treatment Outcome