Parkinson's disease and patient related outcomes in stroke: A matched cohort study

Perdomo-Lampignano, Jesus A., Pana, Tiberiu A., Sleeman, Isobel, Clark, Allan B. ORCID:, Sawanyawisuth, Kittisak, Tiamkao, Somsak and Myint, Phyo K. (2020) Parkinson's disease and patient related outcomes in stroke: A matched cohort study. Journal of Stroke & Cerebrovascular Diseases, 29 (7). ISSN 1052-3057

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Objective: To evaluate post-stroke outcomes in patients with Parkinson's disease (PD). Methods: A matched cohort study was performed. Stroke patients with PD and non-PD controls were extracted from the Thailand Universal Insurance Database. Logistic regressions were used to evaluate the association between PD and in-hospital outcomes (mortality and complications). The PD-associated long-term mortality was evaluated using Royston-Parmar models. Results: A total of 1967 patients with PD were identified between 2003 and 2015 and matched to controls (1:4) by age, sex, admission year, and stroke type. PD patients had decreased odds of in-hospital death: OR (95% CI) 0.66 (0.52 – 0.84) and 0.61 (0.43 – 0.85) after ischaemic and haemorrhagic strokes, respectively. PD was associated with a length-of-stay greater than median (4 days) after both stroke types: 1.37 (1.21 – 1.56) and 1.45 (1.05 – 2.00), respectively. Ischaemic stroke patients with PD also had increased odds of developing pneumonia, sepsis and AKI: 1.52 (1.2 – 1.83), 1.54 (1.16 – 2.05), and 1.33 (1.02 – 1.73). In haemorrhagic stroke patients, PD was associated with pneumonia: 1.89 (1.31 – 2.72). Survival analyses showed that PD was protective against death in the short term (HR=0.66; 95% CI 0.53–0.83 ischaemic, and HR=0.50; 95% CI 0.37 – 0.68 haemorrhagic stroke), but leads to an increased mortality risk approximately 1 and 3 months after ischaemic and haemorrhagic stroke, respectively. Conclusion: PD is associated with a reduced mortality risk during the first 2–4 weeks post-admission but an increased risk thereafter, in addition to increased odds of in-hospital complications and prolonged hospitalisation.

Item Type: Article
Uncontrolled Keywords: haemorrhagic stroke,ischaemic stroke,matched cohort study,parkinson's disease,surgery,rehabilitation,clinical neurology,cardiology and cardiovascular medicine ,/dk/atira/pure/subjectarea/asjc/2700/2746
Faculty \ School: Faculty of Medicine and Health Sciences > Norwich Medical School
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Depositing User: LivePure Connector
Date Deposited: 16 May 2020 00:24
Last Modified: 22 Oct 2022 06:11
DOI: 10.1016/j.jstrokecerebrovasdis.2020.104826

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