title: Increased risk of Parkinsonism among patients with cirrhosis: a 7-year follow-up study.
abstract: OBJECTIVE
  Previous studies have suggested that hepatic (toxic-metabolic) encephalopathy, the major complication of cirrhosis, is a neuropsychiatric disorder typically seen in patients with liver dysfunction after exclusion of other known brain disease. This study aims to investigate the risk for parkinsonism during a 7-year follow-up period after a diagnosis of cirrhosis.
  
  
  METHODS
  In total, 1361 patients with cirrhosis and 6805 comparison patients without cirrhosis were included in this study. Each patient was then individually tracked for 7 years from the time of their initial diagnosis of cirrhosis to identify those who developed parkinsonism during the follow-up period. Stratified Cox proportional hazard regressions were conducted to calculate the hazard of parkinsonism for the two groups during the follow-up period, after adjusting for patient's age, monthly income, level of urbanization and geographic location.
  
  
  RESULTS
  Of the total 8166 sampled patients, 141 (1.7%) developed parkinsonism during the follow-up period, 48 from the study group (3.5% of the patients with cirrhosis) and 93 from the comparison group (1.4% of patients in the comparison group). Stratified Cox proportional hazard regressions show that the hazard for parkinsonism for patients with cirrhosis was 2.65 times as high (95% confidence interval=1.85-3.80, P<0.001) as the patients in the comparison group over the 7-year follow-up period, after adjusting for patient's age, monthly income, level of urbanization and the geographic location of the community in which the patient resided.
  
  
  CONCLUSIONS
  We concluded that cirrhosis significantly increased the risk of parkinsonism.
authors: Neuroscience Research Center, Taipei Medical University Hospital, Taipei, Taiwan.
authors: Jiunn-Horng
authors: JH
authors: Kang
authors: Ming-Chieh
authors: MC
authors: Tsai
authors: Ching-Chun
authors: CC
authors: Lin
authors: Hsiu-Li
authors: HL
authors: Lin
authors: Herng-Ching
authors: HC
authors: Lin
mesh_terms: D000368:Aged; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D019992:Databases as Topic; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D008103:Liver Cirrhosis / Q000453:epidemiology* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D020734:Parkinsonian Disorders / Q000453:epidemiology* / Q000401:mortality; D016016:Proportional Hazards Models; D018570:Risk Assessment; D012307:Risk Factors; D015996:Survival Rate; D013624:Taiwan / Q000453:epidemiology; D013997:Time Factors