Abstract Details

Title End-of-Life Care of Hospitalized Patients with Parkinson's Disease: A Retrospective Study

Topic Palliative Care

Presentation(s) P5 - Poster Session 5 (5:30 PM-6:30 PM)

Poster/Presentation
Number 6-004

Objective

This study describes hospital care and Palliative care (PC) utilization trends for Patients with Parkinsonism (PwP) nearing the End of Life (EOL).

Background PwP face unique challenges at EOL, yet no established guidelines exist for managing their symptoms.

Design/Methods We retrospectively examined 727 PwP admitted to two hospitals in 2018. The EOL population (N=35), comprising patients who died in the hospital or were discharged with hospice care, was compared with the main cohort of PwP discharged without hospice. We studied the demographics, medical data, PC service involvement, length of stay, treatment approaches, and medication administration.

Results In the EOL group, 8 patients died in the hospital, and 27 were discharged with hospice. Approximately 46% of EOL patients received PC consultation during admission. Median time from admission to death was 37 days. Seventy-seven percent of patients were full code on admission, which meant that all medical interventions and life-saving measures would be applied if needed. The EOL group was divided into hospital deaths and hospice care. Patients who died in the hospital had higher rates of invasive procedures and intensive care unit transfers (75% for both), and lower PC engagement (25% vs. 52%). Transitioning from Full code to Do Not Resuscitate (DNR) status took a median of 4.5 days in the hospice group and 5 days in the in-hospital death group. For in-hospital deaths, median time from code status change to death was 0 days. Deviations in levodopa dosing were common in both EOL and non-EOL groups, with infrequent administration of contraindicated medications (11% vs. 9%).

Conclusions Our findings reveal limited PC service utilization and delayed discussions about care goals for PwP. This underscores the need to educate inpatient teams on managing advanced PwP with distinct challenges.

Authors/Disclosures
Sakhi A. Bhansali, MD (Home) PRESENTER	Dr. Bhansali has nothing to disclose.
Ekhlas Assaedi, MD (Cleveland Clinic)	Dr. Assaedi has nothing to disclose.
Nymisha Mandava	Nymisha Mandava has nothing to disclose.
Olivia Hogue	No disclosure on file
Claire Sonneborn	Claire Sonneborn has received personal compensation in the range of $0-$499 for serving as a Consultant with The Sumaira Foundation.
Jeryl Ritzi yu	No disclosure on file
Benjamin L. Walter, MD (Cleveland Clinic)	Dr. Walter has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Acorda. Dr. Walter has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Lundbeck. Dr. Walter has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Medtronic. Dr. Walter has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Teva. Dr. Walter has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Abbott.
Renato Samala (Cleveland Clinic)	No disclosure on file
Adam J. Margolius, MD (Cleveland Clinic)	Dr. Margolius has nothing to disclose.

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