title: Epidemiology of inpatient stay in Parkinson's disease in the United States: Insights from the Nationwide Inpatient Sample.
abstract: The total number of people living with Parkinson's disease (PD) worldwide is expected to double by 2030. The risk factors for emergency department visits in PD patients have been described before, however, there is limited data on inpatient hospitalizations of PD patients. We derived our study cohort from the Nationwide Inpatient Sample (NIS) database from 2002-2011. The NIS is a stratified 20% sample of discharges from all U.S. hospitals. We extracted causes of hospitalization using International Classification of Diseases, 9th revision, Clinical Modification (ICD-9-CM) codes and calculated inpatient mortality, length of stay and cost. Further, the significance of trends over 10 years was assessed. A total of 3,015,645 (weighted) admissions of PD patients were documented from 2002-2011. Pneumonia, urinary tract infection (UTI), septicemia and aspiration pneumonitis were the most common causes of admission, of which incidence of sepsis and UTI was trending up. Of all causes, 3.9% of the admissions resulted in inpatient mortality. Inpatient mortality for PD patients decreased from 4.9% in 2002 to 3.3% in 2011 (p<0.001). The median length of stay has also steadily declined from 3.6days in 2002 to 2.3days in 2011. However, the inflation-adjusted cost of care has been steadily rising, from $22,250 per hospitalization in 2002 to $37,942 in 2011. We conclude that the epidemiology of inpatient admissions in PD has changed significantly over the last decade. Our study underscores the need for future, in-depth prospective studies to explore this changing disease spectrum to design preventive measures and targeted interventions.
authors.affiliation: Department of Neurology, Henry Ford Health System, 2799 W. Grand Boulevard, K-11, Detroit, MI 48202, USA; Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA. Electronic address: amahaja1@hfhs.org.
authors.forename: Abhimanyu
authors.initials: A
authors.lastname: Mahajan
authors.affiliation: Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA.
authors.forename: Poojitha
authors.initials: P
authors.lastname: Balakrishnan
authors.affiliation: Division of Nephrology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
authors.forename: Achint
authors.initials: A
authors.lastname: Patel
authors.affiliation: Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
authors.forename: Ioannis
authors.initials: I
authors.lastname: Konstantinidis
authors.affiliation: Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
authors.forename: Dominic
authors.initials: D
authors.lastname: Nistal
authors.affiliation: Division of Rheumatology, Vanderbilt University Medical Center, Nashville, TN, USA.
authors.forename: Narender
authors.initials: N
authors.lastname: Annapureddy
authors.affiliation: Department of Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
authors.forename: Priti
authors.initials: P
authors.lastname: Poojary
authors.affiliation: Division of Nephrology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
authors.forename: Girish N
authors.initials: GN
authors.lastname: Nadkarni
authors.affiliation: Department of Neurology, Henry Ford Health System, 2799 W. Grand Boulevard, K-11, Detroit, MI 48202, USA.
authors.forename: Christos
authors.initials: C
authors.lastname: Sidiropoulos
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003365:Costs and Cost Analysis; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005260:Female; D006760:Hospitalization / Q000191:economics / Q000706:statistics & numerical data*; D006801:Humans; D007297:Inpatients / Q000706:statistics & numerical data*; D007902:Length of Stay / Q000191:economics / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000150:complications / Q000191:economics / Q000453:epidemiology*; D011014:Pneumonia / Q000453:epidemiology; D018805:Sepsis / Q000453:epidemiology; D014481:United States; D014552:Urinary Tract Infections / Q000453:epidemiology; D055815:Young Adult
keywords: Epidemiology; Inpatient care; Outcomes research; Parkinson’s disease