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Hospital-based study on emergency admission of patients with Parkinson's disease

机译：基于医院的帕金森氏病患者紧急入院研究

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Objective Parkinson's disease (PD) is a progressive neurodegenerative disease. As the severity of disease worsens, patients have lower tolerance for treatments and occasionally need to be hospitalized. This study focuses on characteristics of patients with PD who were emergently admitted to our hospital and evaluates their prognosis during hospitalization. Methods Hospital-based study on emergency admission was conducted in a consecutive series of patients with PD between April 2009 and March 2015. Results A total of 164 admissions involving 136 patients with PD with available medical records were identified. Among these, 40 admissions involving 38 patients were emergency admissions. The most common cause of hospitalization was aspiration pneumonia (n = 17) followed by parkinsonism hyperpyrexia syndrome (n = 6), cerebrovascular disease (n = 2), dehydration (n = 2), and others (n = 13). The mean Hoehn and Yahr stage at admission and discharge were 3.5 and 4.2, respectively, with significant differences between time points (p 0.001). All patients except one presented with either postural instability gait difficulty phenotype (PIGD) or mixed phenotype with PIGD and tremor. All 17 patients with aspiration pneumonia had various combinations of three components: abnormalities seen on videofluoroscopy swallowing study, cognitive impairment, and history of psychiatric symptoms. Conclusion Aspiration pneumonia was the most common reason for emergency admission in patients afflicted with PD for more than five years. Abnormalities seen in videofluoroscopy, PIGD and mixed phenotypes, cognitive impairment, and history of psychiatric symptoms could potentially be predictors for aspiration pneumonia in patients with PD. Highlights ? Patients with Parkinson's disease emergently admitted to our hospital were assessed. ? The most common cause of hospitalization was aspiration pneumonia. ? Mean H&Y stage at admission and discharge were 3.5 and 4.2, respectively. ? Most of patients manifested postural instability gait difficulty phenotype. ? Cognitive impairment and history of psychosis may predict for aspiration pneumonia.
机译：目的帕金森氏病（PD）是一种进行性神经退行性疾病。随着疾病严重程度的恶化，患者对治疗的耐受性降低，偶尔需要住院。这项研究的重点是急诊入院的PD患者的特征，并评估他们在住院期间的预后。方法从2009年4月至2015年3月，在连续的PD患者中进行了基于医院的急诊入院研究。结果确定了164例入院患者，其中136例具有可得病历的PD患者。其中，涉及38例患者的40例入院为急诊入院。住院的最常见原因是吸入性肺炎（n = 17），其次是帕金森病高热综合征（n = 6），脑血管疾病（n = 2），脱水（n = 2）和其他（n = 13）。入院和出院的平均Hoehn和Yahr阶段分别为3.5和4.2，时间点之间存在显着差异（p <0.001）。除一名患者外，所有患者均出现姿势不稳步态困难表型（PIGD）或PIGD和震颤的混合表型。所有17例吸入性肺炎患者均具有以下三个成分的各种组合：吞咽透视检查中发现的异常，认知障碍和精神病史。结论吸入性肺炎是PD病患者五年以上紧急入院的最常见原因。电镜检查，PIGD和混合表型，认知障碍和精神病史的异常可能是PD患者吸入性肺炎的预测指标。强调 ？急诊入院的帕金森氏病患者进行了评估。 ？住院的最常见原因是吸入性肺炎。 ？入院和出院的平均H＆Y阶段分别为3.5和4.2。 ？大多数患者表现出姿势不稳步态困难表型。 ？认知障碍和精神病史可预示吸入性肺炎。

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