title: Mortality of advanced Parkinson's disease patients treated with deep brain stimulation surgery.
abstract: Despite the widespread use of deep brain stimulation (DBS) for patients with Parkinson's disease (PD), long-term outcomes remain unclear. We aimed to analyze the mortality of advanced PD patients who received DBS surgery.
  
  
  
  We assessed the survival rate of 158 consecutive advanced PD patients who underwent DBS surgery between April 2002 and May 2014. Kaplan-Meier survival curves were constructed using death as the endpoint. Cox proportional hazards regression models were used to assess the association of clinical risk factors with survival.
  
  
  
  Twenty-seven (17.1%) PD patients (13 men and 14 women) died during the mean follow-up period of 5.3±3.1years. The survival rate was 97% at 3years and 85% at 5years after DBS surgery. Pneumonia (n=7) was the most common specific cause of death. Orthostatic hypotension was more frequent in deceased patients than in survivors (P=0.026). In a step-wise Cox regression analysis, male sex (hazard ratio (HR) = 2.58; 95% confidence interval (CI) = 1.19–5.60; P = 0.016), visual hallucination (HR = 9.53; 95% CI = 3.50–26.01; P < 0.001), and nursing home admission (HR = 6.76; 95% CI = 2.40–18.99; P < 0.001) predicted poor survival.
  
  
  
  The poor survival of advanced PD patients who underwent DBS surgery was associated with male sex, orthostatic hypotension, visual hallucination, and nursing home admission.
authors.affiliation: Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
authors.forename: Ho-Sung
authors.initials: HS
authors.lastname: Ryu
authors.affiliation: Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
authors.forename: Mi Sun
authors.initials: MS
authors.lastname: Kim
authors.affiliation: Department of Neurology, Dongsan Medical Center, Keimyung University, Daegu, South Korea.
authors.forename: Sooyeoun
authors.initials: S
authors.lastname: You
authors.affiliation: Department of Neurology, Bobath Memorial Hospital, Seongnam, South Korea.
authors.forename: Mi-Jung
authors.initials: MJ
authors.lastname: Kim
authors.affiliation: Department of Neurology, Best Heals Hospital, Ansan, South Korea.
authors.forename: Young Jin
authors.initials: YJ
authors.lastname: Kim
authors.affiliation: Department of Neurology, Metro Hospital, Anyang, South Korea.
authors.forename: Juyeon
authors.initials: J
authors.lastname: Kim
authors.affiliation: Department of Neurology, Gangnam-gu Haengbok Convalescence Hospital, Seoul, South Korea.
authors.forename: Kiju
authors.initials: K
authors.lastname: Kim
authors.affiliation: Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea. Electronic address: sjchung@amc.seoul.kr.
authors.forename: Sun Ju
authors.initials: SJ
authors.lastname: Chung
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000818:Animals; D002423:Cause of Death; D046690:Deep Brain Stimulation / Q000379:methods*; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008137:Longitudinal Studies; D008297:Male; D008609:Mental Status Schedule; D008875:Middle Aged; D010300:Parkinson Disease / Q000401:mortality* / Q000628:therapy*; D012189:Retrospective Studies; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric; D016896:Treatment Outcome; D055815:Young Adult
keywords: Deep brain stimulation; Mortality; Outcome; Parkinson's disease