1
|
Ukenenye E, Oshiba T, Okoronkwo E, Obomanu E, Asaolu G, Urhi A, Olateju IV, Onyemarim H, Uzzi C, Alugba G, Oladunjoye AF, Oladunjoye O. Quivering hand and heart: Parkinson's disease is not associated with increased in-hospital mortality in atrial fibrillation hospitalizations: A nationwide analysis. Heliyon 2023; 9:e14725. [PMID: 37009247 PMCID: PMC10060677 DOI: 10.1016/j.heliyon.2023.e14725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 03/15/2023] [Accepted: 03/15/2023] [Indexed: 03/29/2023] Open
Abstract
Background Autonomic dysfunction in Parkinson's disease (PD) includes cardiovascular dysregulations which may manifest as an increased risk of atrial fibrillation (AF). However, data on the impact of PD in AF patients is lacking. Our study aimed to investigate the differences in in-hospital mortality of patients admitted for AF with underlying PD versus those without PD. Methods We examined the National Inpatient Sample (NIS) database from 2016 to 2019 for hospitalizations of AF as a principal diagnosis with and without PD as a secondary diagnosis. The primary outcome was inpatient mortality. The secondary endpoints were ventricular tachycardia (VT), ventricular fibrillation (VF), acute heart failure (AHF), cardiogenic shock (CS), cardiac arrest (CA), total hospital charge (THC), and length of stay (LOS). Results Of 1,861,859 A F hospitalizations, 0.01% (19,490) had coexisting PD. Cohorts of PD vs No-PD had a mean age of 78.1 years [CI 77.9-78.4] vs 70.5 years [CI 70.4-70.5]; male (56.3% vs 50.7%), female (43.7% vs 49.3%). The PD category had similar in-hospital mortality with the no-PD category (ORAdj = 1.18 [0.89-1.57] P = 0.240). The PD group had a lesser incidence of AHF (ORAdj = 0.79 [0.72-0.86] P < 0.001) and VT (ORAdj = 0.77 [0.62-0.95] P = 0.015). Conclusion Co-existing PD in patients admitted for AF was not associated with increased in-hospital mortality; however, there were lower odds of AHF and VT. The diminished arrhythmogenic neurohormonal axis may explain these cardiovascular benefits. Notwithstanding, to better understand the outcomes of AF in patients with PD, additional studies are required.
Collapse
Affiliation(s)
- Emmanuel Ukenenye
- One Brooklyn Health-Brookdale University Hospital and Medical Center Medical, Brooklyn, NY, United States
- Medical Council of Jamaica, University of the West Indies, 18 West Rd, Kingston, 2762+3VM, Jamaica
- Corresponding author. One Brooklyn Health-Brookdale University Hospital and Medical Center Medical, Brooklyn, NY, United States
| | - Tolulope Oshiba
- Hospitalist/Emergency Medicine Department, University of Texas Health Science Center/UT Physicians/Memorial Hermann Hospital, 6410 Fannin St, Houston, TX 77030, United States
| | - Emeka Okoronkwo
- Neurology Unit of Department of Medicine, Lagos University Teaching Hospital, Ishaga Rd, Idi-Araba, Lagos 102215, Nigeria
| | - Elvis Obomanu
- Department of Project Management, Translational Research in Oncology, 9925 109 St NW Suite 1100, Edmonton, AB T5K 2J8, Alberta, Canada
| | - Gideon Asaolu
- Mandeville Regional Hospital, Mandeville, Manchester, Jamaica
| | - Alexsandra Urhi
- Federal Neuropsychiatric Hospital, New Lagos Rd, Uselu 300103, Benin City, Edo, Nigeria
| | - Iyanu Victoria Olateju
- Department of Internal Medicine, Medstar Union Memorial Hospital, 201 E University Pkwy, Baltimore, MD 21218, United States
| | - Henry Onyemarim
- Asaba Specialist Hospital, GRA Phase 1 320108, Asaba, Delta State, Nigeria
| | - Consolata Uzzi
- Columbus Specialty Hospital, 495 N 13th St, Newark, NJ 07107, United States
| | - Gabriel Alugba
- Delta State University, Abraka - Abbi Rd, 330105, Uruoka, Nigeria
| | - Adeolu Funso Oladunjoye
- Clinical Menninger Department of Psychiatry, Baylor College of Medicine, Houston TX 77030, United States
| | - Olubunmi Oladunjoye
- Section of General Internal Medicine, Baylor College of Medicine, 7200 Cambridge St, Houston, TX 77030, United States
| |
Collapse
|
2
|
Wang J, Xiong K, Chao J, Zhuang S, Li J, Liu C. Seasonal variations of nonmotor symptoms in patients with Parkinson's disease in Southeast China. Chin Med J (Engl) 2023; 136:415-422. [PMID: 35970598 PMCID: PMC10106254 DOI: 10.1097/cm9.0000000000002276] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Studies suggest seasonal fluctuations of symptoms in Parkinson's disease (PD) patients in Western countries. However, the association between seasonal change and variation in nonmotor symptoms (NMS) in Chinese PD patients is unclear. Here, we studied whether there is a change rule with annual cycle with severity of NMS for patients with PD in Southeast China. METHODS We studied 1005 PD patients between April 2008 and October 2020. Patients were classified into four seasons according to the 24 Chinese solar terms, based on assessment date. We compared comprehensive NMS scales and polysomnography parameters among groups and conducted further analysis of disease severity. RESULTS Among the 1005 patients studied, the mean age was 64.2 ± 9.7 years and 569 (56.6%) of them were men. Relative to the summer group, patients assessed during winter had higher Scales for Outcomes in Parkinson's disease-Autonomic Dysfunction (SCOPA-AUT) scores ( P = 0.045). The sleep efficiency factor scores of Pittsburgh Sleep Quality Index in patients were higher during spring than summer ( P = 0.009). Among patients who completed polysomnography during the same period ( n = 135), compared with summer follow-ups, we observed a higher percentage of NREMS1 in winter and spring follow-ups ( P = 0.042, P = 0.011), a higher NREMS1 time in spring follow-ups ( P = 0.0024), a lower NREMS2 time in winter follow-ups ( P = 0.007), and a higher percentage of phasic rapid eye movement (REM)-sleep without atonia in autumn and winter follow-ups ( P = 0.026 and P = 0.020, respectively). In a subset of patients with PD and REM sleep behavior disorder (RBD; n = 182), those visited during winter had higher scores for RBD questionnaire-Hong Kong and its factor 1 (dream-related sub-score) than those visited during summer ( P = 0.034, P = 0.020). We observed similar findings for SCOPA-AUT and sleep efficiency factor scores in early stage patients in subgroup analysis. CONCLUSIONS PD patients assessed for follow-up during summer showed less severe symptoms of autonomic dysfunction and RBD symptoms than those assessed in winter, and less sleep disturbance than those in spring and winter, suggesting that seasonal change and NMS fluctuation are related, especially in patients with early stage PD.
Collapse
Affiliation(s)
- Jingyi Wang
- Department of Neurology and Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215004, China
| | - Kangping Xiong
- Sleep Center, The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215004, China
| | - Jingyuan Chao
- Department of Neurology and Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215004, China
| | - Sheng Zhuang
- Department of Neurology and Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215004, China
| | - Jie Li
- Department of Neurology and Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215004, China
- Sleep Center, The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215004, China
| | - Chunfeng Liu
- Department of Neurology and Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215004, China
- Sleep Center, The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215004, China
- Institute of Neuroscience, Soochow University, Suzhou, Jiangsu 215123, China
| |
Collapse
|