title: Outcomes After Non-neurological Surgery in Patients With Parkinson's Disease: A Nationwide Matched Cohort Study.
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 from Taiwan's National Health Insurance Research Database, we conducted a nationwide retrospective cohort study of 6455 patients with preoperative PD receiving major 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.
authors.affiliation: From the Department of Anesthesiology, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan (YFH, YGC); Department of Anesthesiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan (YFH, YGC, TLC, CCL); Department of Physical Medicine and Rehabilitation, China Medical University Hospital, China Medical University, Taichung, Taiwan (YCC); Department of Surgery, China Medical University Hospital, China Medical University, Taichung, Taiwan (CCY); Department of Surgery, University of Illinois, Chicago, United States of America (CCY); Department of Neurology, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan (CJH); Department of Anesthesiology, Taipei Medical University Hospital, Taipei, Taiwan (Chen, Liao); Health Policy Research Center, Taipei Medical University Hospital, Taipei, Taiwan (TLC, CCL); School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan (CCL).
authors.forename: Yu-Feng
authors.initials: YF
authors.lastname: Huang
authors.forename: Yi-Chun
authors.initials: YC
authors.lastname: Chou
authors.forename: Chun-Chieh
authors.initials: CC
authors.lastname: Yeh
authors.forename: Chaur-Jong
authors.initials: CJ
authors.lastname: Hu
authors.forename: Yih-Giun
authors.initials: YG
authors.lastname: Cherng
authors.forename: Ta-Liang
authors.initials: TL
authors.lastname: Chen
authors.forename: Chien-Chang
authors.initials: CC
authors.lastname: Liao
mesh_terms: D000368:Aged; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000150:complications*; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology*; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013624:Taiwan