Objective: Provide national outcomes on readmissions after elective orthopedic surgery in Parkinson’s disease (PD).

Background: Advances in the treatment of PD have allowed for improvements in mortality and quality survival. Therefore, the management of comorbid conditions of aging, such as osteoarthritis, are crucial, as they may have a greater impact on PD survival and function than PD itself, especially in the early and middle stages of the disease.

Methods: This retrospective cohort study included adults ages 40 and above, with and without PD, who were hospitalized for an elective orthopedic surgery. Data used in this study came from the National Readmissions Database (NRD) for the years 2013 and 2014. Our primary outcome was non-elective readmission within 30 days. Logistic regression was used to compare the odds of readmission for PD patients compared to non-PD, adjusting for age, sex, socioeconomic status, expected payer, Elixhauser comorbidity score, index admission length of stay, year and discharge disposition. Clinical conditions associated with readmission were compared between the two groups.

Results: A total of 4,781 subjects with PD and 947,475 subjects without PD were identified who had undergone elective orthopedic surgery in 2013 or 2014. Length of stay (LOS) during the index admission was longer for PD patients, with a quarter having a LOS of 4 or more days compared to 15% of non-PD patients. In addition, PD patients were much more likely to be discharged to inpatient post-acute care (49.3% vs 26.2%) while non-PD subjects were more likely to be discharged home with (31.9% [PD] vs 44.8% [non-PD]) or without home health (18.7% [PD] vs 28.9% [non-PD]). A total of 271 PD patients (5.66%) and 28,079 non-PD patients (2.96%) were readmitted within 30 days following surgery. After adjusting for age, sex, socioeconomic status, expected payer, comorbidities, index admission LOS, year and discharge disposition, PD subjects were 31% more likely to be readmitted than non-PD subjects (AOR 1.31, 1.07-1.62). For the PD group, only discharge disposition was associated with readmission. Over 50% of PD patients were readmitted with infection as a primary or secondary diagnosis compared to 38% of non-PD patients, and the rates of MRSA were twice as high in PD patients.

Conclusions: Parkinson’s disease patients had longer LOS, were less likely to be discharged home and were more likely to be readmitted following elective orthopedic surgery compared to non-PD patients.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/outcomes-of-elective-orthopedic-surgery-in-parkinsons-disease-a-nationwide-study/