The following is a summary of “Emergency Department Visits in Parkinson’s Disease: The Impact of Comorbid Conditions,” published in the January 2024 issue of Emergency Medicine by Al-Hakeem, et al.

Elderly individuals often contend with intricate medical conditions, necessitating meticulous management that may elevate their utilization of emergency department (ED) services compared to younger counterparts. Parkinson’s disease (PD), characterized by progressive neurodegeneration encompassing distinctive motor and nonmotor symptoms, frequently coexists with additional comorbidities. Categorizing these comorbidities into clinical subgroups facilitates a deeper understanding of the variability in outcomes among PD patients. For a study, researchers sought to explore the underlying reasons for ED visits in a cohort of PD patients and to pinpoint comorbidities that could serve as potential risk factors for specific ED presentations.

Utilizing data from Optum’s de-identified Integrated Claims-Clinical dataset spanning 2010 to 2018, PD patients were identified based on ICD-9/10 diagnosis codes. All ED visits after the initial PD diagnosis code were identified. Comorbidities were classified using the AHRQ Clinical Classification Software (CCS). Latent Class Analysis (LCA) was employed to categorize patients, and multiple logistic regression models were constructed to analyze the associations between reason-for-visit outcomes, comorbidity profile class, patient demographics, and socio-economic characteristics.

The primary reasons for ED admission encompassed injuries such as fractures and contusions, diseases of the circulatory system, and general signs and symptoms like abdominal pain, malaise, and fatigue. Common comorbidities observed in this patient cohort included depression, diabetes mellitus, and chronic pulmonary disease. Patients classified under the “Poorest Health” category in the LCA exhibited heightened odds of ED admission for gastrointestinal and musculoskeletal system diseases, as well as injury/poisoning categories, while showing diminished odds for admission due to circulatory system diseases.

PD patients presenting to the ED with injuries tend to have poorer overall health and a heavier burden of comorbidities. Understanding the intricate medical needs of PD patients is crucial for tailoring care strategies, potentially mitigating ED visits, enhancing quality of life, and alleviating strain on the healthcare system.

Reference: sciencedirect.com/science/article/abs/pii/S0735675723005594