Objective: To study the characteristics and the outcome of patients with Parkinson’s disease admitted to intensive care unit.

Background: Whereas Parkinson’s disease is associated with an increased risk of severe septic complications that can lead to intensive care unit (ICU) admissions, relevant data regarding the characteristics of PD patients admitted in ICU together with their vital and functional prognosis are lacking.

Method: We performed a retrospective study in a single tertiary referral center (Paris, France) that includes both a Parkinson’s disease clinics and several ICU. Cases were identified through a search in our institutional database (PMSI). Overall, 101 patients  with a diagnosis of PD admitted to one of the ICU between 1999 and 2014  were identified. We excluded 49 patients because of incorrect diagnosis (n = 20), missing files (n = 13) or incomplete data (n = 6). Finally, 62 patients were analyzed. Charts were retrospectively reviewed and the following data were collected: demographics, PD duration and severity (including motor and non-motor signs), PD treatments before admission to ICU, reason of admission to ICU ICU stay characteristics (duration, need for vasopressin drugs or respiratory support). Outcome was assessed with survival and functional evaluation up to 18 months after discharge

Results: On admission, patients  profiles in term of age, duration and severity of PD were heterogenous. The admission reason was sepsis for 59% of patients (n=61) and 85% had at least one sepsis during the ICU stay (n=60). Mortality rate was 12.5% (n = 55) after the ICU stay and tended to increase over the 18 months of follow-up. A Hoehn and Yahr (HY) score greater than 3 was associated with an extra mortality at one month (M1) (OR=13,22 ; IC 95% [1,4-124,9]). The HY  score significantly increased from baseline to one month after ICU discharge (2.95 vs 3.0, p = 0.031) and did not improve until at 9 months and 18 months follow-up. The proportion of subjects with cognitive disorders increased to reach over 30% at 18 months follow-up. Only 38% of patients had returned home at this time point.

Conclusion: ICU admission, mostly for a sepsis, marks a turning point in the course of Parkinson’s disease. Larger prospective studies are required to assess more accurately the impact of ICU stay on Parkinson disease evolution.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/characteristics-and-outcome-of-patients-with-parkinsons-disease-admitted-to-intensive-care-unit/