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.
|Journal||Journal of Stroke & Cerebrovascular Diseases|
|Early online date||10 May 2020|
|Publication status||Published - Jul 2020|
- Haemorrhagic stroke
- Ischaemic stroke
- Matched cohort study
- Parkinson's disease
- Norwich Medical School - Associate Professor
- Epidemiology and Public Health - Member
- Health Services and Primary Care - Member
- Norwich Clinical Trials Unit - Member
- Public Health and Health Services Research - Member
Person: Research Group Member, Academic, Teaching & Research