Postoperative complications in Parkinson's disease

BACKGROUND: Although Parkinson's disease is relatively common in America, w ith an average annual incidence of 20 cases per 100,000 population,(1) litt le information exists about postoperative morbidity and mortality in those Parkinson's patients who undergo elective surgery. METHODS: We performed a retrospective cohort study using the Veterans Affai rs (VA) Austin database system (a cumulative index of admissions and discha rges from all US VA Medical Centers) to identify 41,213 patients who underw ent elective bowel resection, cholecystectomy, or radical prostatectomy bet ween January 1, 1990, and December 31, 1995. We examined the study populati on using univariate analysis, acute length of stay with multivariate analys is, and postoperative complications with logistic regression. RESULTS: The selected surgeries were performed on 234 patients with a diagn osis of Parkinson's disease and 40,979 with no such diagnosis. In univariat e analysis, patients with Parkinson's disease had significantly longer acut e hospital stars than non-Parkinson's patients (11.4 +/- 15.9 days vs 8.8 /- 9.0 days, P < .001). In addition, Parkinson's patients had a higher in-h ospital mortality than non-Parkinson's patients (7.3% vs 3.8%, P = .006). A fter we adjusted for coexisting morbidity, age, admitting location, and gen der, patients with Parkinson's disease had an average acute hospital stay 2 .34 days longer than that of non-Parkinson's patients (P < .001). However, the mortality difference did not reach statistical significance in multivar iate analysis (P = .098). Finally, Parkinson's patients had significantly i ncreased incidences of urinary-tract infection (odds ratio 2.045, P < .001) , aspiration pneumonia (odds ratio 3.825, P < .001), and bacterial infectio ns (odds ratio 1.682, P < .001). CONCLUSIONS: Patients with Parkinson's disease are at greater risk for spec ific complications and longer hospital stay after elective bowel resection, cholecystectomy, or radical prostatectomy. Awareness of these complication s may help caregivers to reduce postoperative mortality and morbidity and t o decrease the length of hospitalization.