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Archives of Orthopaedic and Trauma Surgery

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01-11-2015 | Trauma Surgery

Impact of Parkinson’s disease on the acute care treatment and medium-term functional outcome in geriatric hip fracture patients

Authors: Christopher Bliemel, Ludwig Oberkircher, Daphne-Asimenia Eschbach, Philipp Lechler, Monika Balzer-Geldsetzer, Steffen Ruchholtz, Benjamin Buecking

Published in: Archives of Orthopaedic and Trauma Surgery | Issue 11/2015

Abstract

Introduction

Patients with Parkinson’s disease (PD) have a heightened risk of sustaining hip fractures due to disturbed balance and gait insecurity. This study aims to determine the impact of PD on the perioperative course and medium-term functional outcome of patients with hip fractures.

Materials and methods

A total of 402 hip fracture patients, aged ≥60 years, were prospectively enrolled. On admission, the American Society of Anesthesiologists score, Mini-Mental Status Examination, and Barthel Index (BI), among other scales, were documented. The Hoehn and Yahr scale was used to assess the severity of PD. The functional outcome was assessed by performance on the BI, Tinetti test (TT), and Timed Up and Go test (TUG) at discharge and at the 6-month follow-up. Additionally, the length of hospitalization, perioperative complications, and discharge management were documented. A multivariate regression analysis was performed to control for influencing factors.

Results

A total of 19 patients (4.7 %) had a concomitant diagnosis of PD. The functional outcome (BI, TT, and TUG) was comparable between groups (all p > 0.05). Grade II (52.6 vs. 26.1 %; OR = 4.304, p = 0.008) and IV complications (15.8 vs. 4.4 %; OR = 7.785, p = 0.012) occurred significantly more often among PD patients. While the diagnosis of PD was associated with a significantly longer mean length of hospital stay (β = 0.119, p = 0.024), the transfer from acute hospital care showed no significant difference (p = 0.246). Patients with an additional diagnosis of PD had inferior results in BI at the 6-month follow-up (p = 0.038).

Conclusion

PD on hospital admission is not an independent risk factor for in-hospital mortality or an inferior functional outcome at hospital discharge. However, patients with PD are at risk for specific complications and longer hospitalization at the time of transfer from acute care so as for reduced abilities in activities of daily living in the medium term.

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Title: Impact of Parkinson’s disease on the acute care treatment and medium-term functional outcome in geriatric hip fracture patients
Authors: Christopher Bliemel
Ludwig Oberkircher
Daphne-Asimenia Eschbach
Philipp Lechler
Monika Balzer-Geldsetzer
Steffen Ruchholtz
Benjamin Buecking
Publication date: 01-11-2015
Publisher: Springer Berlin Heidelberg
Published in: Archives of Orthopaedic and Trauma Surgery / Issue 11/2015
Print ISSN: 0936-8051
Electronic ISSN: 1434-3916
DOI: https://doi.org/10.1007/s00402-015-2298-3

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Springer Medicine

Impact of Parkinson’s disease on the acute care treatment and medium-term functional outcome in geriatric hip fracture patients

Abstract

Introduction

Materials and methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Introduction

Materials and methods

Results

Conclusion

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