Highlights
- •Age-related comorbidities such as malignancy is important for Parkinson's disease (PD) patients.
- •Using a nationwide database, we investigated the association between PD and outcomes of gastrointestinal cancer surgeries.
- •PD patients were less likely to be discharged to home after surgery for gastrointestinal cancers.
- •Clinicians are required to improve the perioperative care of PD patients.
Abstract
Background
Parkinson's disease (PD) patients with comorbid cancers are increasing in aging populations.
However, little is known about the impact of PD on the outcomes of surgeries to resect
these cancers. We sought to clarify the association between PD and discharge status
of patients who underwent surgery for gastrointestinal cancers, as the most prevalent
malignant neoplasms worldwide.
Methods
We identified patients who underwent surgery for gastric and colorectal cancers between
April 01, 2014 and March 31, 2018 using the Diagnosis Procedure Combination database,
a nationwide administrative inpatient database in Japan. We then collected data on
their sex, age, smoking status, body mass index, activities of daily living, cancer
stage, and comorbidities. Multivariable Cox regression analyses were conducted to
determine factors that influenced discharge to home.
Results
Compared with non-PD patients (n = 272,668), PD patients (n = 1341) were significantly
older and less likely to receive laparoscopic surgery, and had lower body mass index,
more advanced cancer stage, and lower activities of daily living. The proportions
of PD and non-PD patients discharged to home were 80.3% and 96.2%, respectively. The
adjusted hazard ratio for discharge to home for PD patients was 0.68 (95% confidence
interval, 0.64–0.73; P < 0.001).
Conclusions
Compared with non-PD patients, PD patients were less likely to be discharged to home
after surgery for gastrointestinal cancers. The present results may indicate a necessity
to improve perioperative care for patients with PD.
Keywords
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References
- Parkinson's disease.Lancet. 2009; 373: 2055-2066https://doi.org/10.1016/S0140-6736(09)60492-X
- World Report on Ageing and Health.World Health Organization, 2015
- Cancer burden in the year 2000. The global picture.Eur. J. Cancer. 2001; 37: 4-66https://doi.org/10.1016/s0959-8049(01)00267-2
- Differential risks of cancer types in people with Parkinson's disease: a national record-linkage study.Eur. J. Cancer. 2014; 50: 2456-2462https://doi.org/10.1016/j.ejca.2014.06.018
- A prospective cohort study of cancer incidence following the diagnosis of Parkinson's disease.Cancer Epidemiol. Biomarkers Prev. 2007; 16: 1260-1265https://doi.org/10.1158/1055-9965.EPI-07-0038
- Survival and cause of death in a cohort of patients with parkinsonism: possible clues to aetiology?.J. Neurol. Neurosurg. Psychiatry. 1995; 58: 293-299https://doi.org/10.1136/jnnp.58.3.293
- Causes of death in a community-based study of Parkinson's disease.Acta Neurol. Scand. 2001; 103: 7-11https://doi.org/10.1034/j.1600-0404.2001.00191.x
- Managing Parkinson's disease during surgery.BMJ. 2010; 341: c5718https://doi.org/10.1136/bmj.c5718
- Perioperative management of patients with Parkinson's disease.Am. J. Med. 2014; 127: 275-280https://doi.org/10.1016/j.amjmed.2013.11.014
- Neuroleptic malignant syndrome.Ann. Pharmacother. 2016; 50: 973-981https://doi.org/10.1177/1060028016657553
- Postoperative complications in Parkinson's disease.J. Am. Geriatr. Soc. 1999; 47: 967-972https://doi.org/10.1111/j.1532-5415.1999.tb01292.x
- Parkinson's disease influences the perioperative risk profile in surgery.Langenbeck's Arch. Surg. 2009; 394: 511-515https://doi.org/10.1007/s00423-008-0404-5
- Factors associated with discharge to home versus discharge to institutional care after inpatient stroke rehabilitation.Arch. Phys. Med. Rehabil. 2015; 96: 1297-1303https://doi.org/10.1016/j.apmr.2015.03.007
- Clinical epidemiology and health services research using the Diagnosis Procedure Combination database in Japan.Asian Pac. J. Dis. Manag. 2015; 7: 19-24
- Categorized diagnoses and procedure records in an administrative database improved mortality prediction.J. Clin. Epidemiol. 2015; 68: 1028-1035https://doi.org/10.1016/j.jclinepi.2014.12.004
- Validity of diagnoses, procedures, and laboratory data in Japanese administrative data.J. Epidemiol. 2017; 27: 476-482https://doi.org/10.1016/j.je.2016.09.009
- Evaluation of antiparkinsonian drugs in pharmacy records as a marker for Parkinson's disease.Pharm. World Sci. 2001; 23: 148-152https://doi.org/10.1023/a:1011807919632
- Updating and validating the Charlson comorbidity index and score for risk adjustment in hospital discharge abstracts using data from 6 countries.Am. J. Epidemiol. 2011; 173: 676-682https://doi.org/10.1093/aje/kwq433
- Missing covariate data in clinical research: when and when not to use the missing-indicator method for analysis.CMAJ (Can. Med. Assoc. J.). 2012; 184: 1265-1269https://doi.org/10.1503/cmaj.110977
- Analysis of partially observed clustered data using generalized estimating equations and multiple imputation.STATA J. 2014; 14: 863-883
- Mortality and morbidity after spinal surgery in patients with Parkinson's disease: a retrospective matched-pair cohort study.Spine J. 2017; 17: 531-537https://doi.org/10.1016/j.spinee.2016.10.024
- Lumbar spine surgery in patients with Parkinson disease.J. Bone Joint Surg. Am. 2015; 97: 1661-1666https://doi.org/10.2106/JBJS.N.01049
- Impact of Parkinson's disease on perioperative complications and hospital cost in multilevel spine fusion: a population-based analysis.J. Clin. Neurosci. 2017; 35: 88-91https://doi.org/10.1016/j.jocn.2016.10.008
- Cardiac surgery in patients with Parkinson's disease: a retrospective analysis of a high-risk cohort.Thorac. Cardiovasc. Surg. 2018; 66: 629-636https://doi.org/10.1055/s-0037-1603589
- Impaired efficacy of cough in patients with Parkinson disease.Chest. 2003; 124: 1009-1015https://doi.org/10.1378/chest.124.3.1009
- Swallowing disorders in Parkinson's disease: impact of lingual pumping.Int. J. Lang. Commun. Disord. 2015; 50: 659-664https://doi.org/10.1111/1460-6984.12158
- The epidemiology of Parkinson's disease: risk factors and prevention.Lancet Neurol. 2016; 15: 1257-1272https://doi.org/10.1016/S1474-4422(16)30230-7
- Body mass index, diabetes, and the risk of Parkinson's disease.Mov. Disord. 2020; 35: 236-244https://doi.org/10.1002/mds.27922
- Predictors of functional dependency in Parkinson's disease.Mov. Disord. 2016; 31: 1482-1488https://doi.org/10.1002/mds.26751
- The self-report Barthel Index: preliminary validation in people with Parkinson's disease.Eur. J. Neurol. 2012; 19: 927-929https://doi.org/10.1111/j.1468-1331.2011.03592.x
Article info
Publication history
Published online: February 11, 2022
Accepted:
February 6,
2022
Received in revised form:
January 31,
2022
Received:
October 5,
2021
Identification
Copyright
© 2022 Elsevier Ltd. All rights reserved.
