Abstract Details

Title Outcomes of Elective Orthopedic Surgery in Parkinson’s disease – a Nationwide Study

Topic Movement Disorders

Presentation(s) P3 - Poster Session 3 (5:30 PM-6:30 PM)

Poster/Presentation
Number 10-045

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

Background Advances in PD treatment have improved mortality and quality survival, therefore, the management of comorbid conditions of aging, such as osteoarthritis, are crucial to maintain function.

Design/Methods

This retrospective cohort study included adults ages 40 and above, with and without PD, who were hospitalized for an elective orthopedic surgery. Data 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 patients, adjusting for age, sex, socioeconomic status, expected payer, Elixhauser comorbidity score, index admission length of stay (LOS), 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 met inclusion criteria. LOS during the index admission was longer for PD patients. PD patients were 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. In adjusted analysis, 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.

Conclusions Overall readmission rates were low. 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.

Authors/Disclosures
Michelle Fullard, MD (University of Colorado Anschutz) PRESENTER	Dr. Fullard has received research support from Davis Phinney Foundation. Dr. Fullard has received research support from Michael J. Fox Foundation. The institution of Dr. Fullard has received research support from NIH BIRCWH K12. Dr. Fullard has received research support from Lorna G. Moore Faculty Launch Fund.
	No disclosure on file
	No disclosure on file
James Crispo	No disclosure on file
Allison Wright Willis, MD (University of Pennsylvania)	Dr. Wright Willis has received personal compensation in the range of $0-$499 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Pharmacoepidemiology and Drug Safety. Dr. Wright Willis has received personal compensation in the range of $0-$499 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for JAMA Neurology. The institution of Dr. Wright Willis has received research support from NIH. The institution of Dr. Wright Willis has received research support from NIA. The institution of Dr. Wright Willis has received research support from Biogen. The institution of Dr. Wright Willis has received research support from Parkinson Foundation. The institution of Dr. Wright Willis has received research support from Arcadia.

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