Factors associated with hospitalisation among people with Parkinson's disease - A systematic review and meta-analysis

Introduction: Parkinson's disease (PD) is associated with an increased risk of admission to hospital; however data on the main reasons for admission are lacking. Our objective was to determine the pooled prevalence of the most common factors leading to admission among people with Parkinson's disease. Methodology: A systematic literature search was conducted in 11 electronic databases. We included all studies providing reasons for admissions among PD patients without restrictions to diagnostic criteria of PD, language or year of study. In the included studies, methodological quality, publication bias and heterogeneity were assessed. Meta-analysis was performed using random-effects models to calculate the pooled estimates of the identified top factors that lead to admission among people with PD. Results: A total of 7283 studies were identified of which nine studies including 7162 people with PD were included in this review. There was a high degree of heterogeneity between studies regarding reasons for hospitalisation. The pooled prevalence of the topmost reasons for hospitalisation among people with PD was 22% (95%CI 16.0%-30.0%) for infections (mainly urinary tract infections and pneumonia); 19% (95%CI 13.0%-27.0%) for worsening motor manifestations of PD; 18% (95%CI 14.0%-21.0%) for falls/fractures; 13% (95%CI 9.0%-18%) for cardiovascular co-morbidities; 8% (95%CI 4.0%-13.0%) for neuropsychiatric and 7% (95%CI 4.0%-11.0%) for gastrointestinal complications. Conclusion: The main reasons for hospitalisation among people with PD are infections, worsening motor features, falls/fractures, cardiovascular co-morbidities, neuropsychiatric and gastrointestinal complications. Further research is needed on targeting and implementing preventative strategies.