In-hospital outcomes and documented 90-day readmission to the index hospital in older patients with Parkinson's disease hospitalised for lower respiratory tract infection: a single-centre retrospective cohort study.

Authors

Yue Zou, JinRong Li, SiWei Luo

Published in

Frontiers in neurology. Volume 17. Pages 1861214. Epub Sep 16, 2026.

Abstract

Lower respiratory tract infection (LRTI) is a major cause of hospitalisation in older adults with Parkinson's disease (PD), but it remains uncertain whether PD-related measures provide clinically relevant information beyond general vulnerability and acute infection severity.
We conducted a single-centre retrospective cohort study of patients aged ≥65 years with neurologist-diagnosed PD who were hospitalised for LRTI between 2018 and 2025. The primary outcome was a composite of intensive care unit admission, invasive mechanical ventilation, or in-hospital death. Documented readmission to the index hospital within 90 days among survivors was analysed as a secondary exploratory outcome. Multivariable logistic and Cox regression models evaluated clinical factors associated with these outcomes. A hierarchical extension added Hoehn-Yahr stage and pre-admission wheelchair- or bed-bound status to the base clinical model. Calendar-period analyses and bootstrap internal validation were performed.
Among 246 patients, 62 (25.2%) experienced the composite in-hospital outcome. In the PD-specific extended model, higher Charlson Comorbidity Index (adjusted odds ratio [OR] per 1-point increase 1.19, 95% confidence interval [CI] 1.00-1.42), hypoxaemia (OR 2.00, 95% CI 1.01-3.96), serum albumin <35 g/L (OR 3.18, 95% CI 1.65-6.14), sepsis or septic shock (OR 2.41, 95% CI 1.17-4.98), and pre-admission wheelchair- or bed-bound status (OR 2.08, 95% CI 1.08-4.01) were associated with the outcome. Hoehn-Yahr stage, PD duration, tube feeding, and antiparkinsonian medication burden were not independently associated. Among 228 patients discharged alive, 74 (32.5%) had a documented readmission to the index hospital. Hypoalbuminaemia (adjusted hazard ratio [HR] 1.82, 95% CI 1.12-2.95) and non-home discharge (HR 1.96, 95% CI 1.19-3.24) were among the factors associated with documented same-hospital return. Bootstrap-corrected discrimination was 0.81 for the extended logistic model and 0.70 for the Cox model.
Severe in-hospital deterioration was associated mainly with general physiological vulnerability, acute infection severity, and pre-admission mobility dependence, whereas most other available PD-specific measures showed no clear independent association. These findings support integrated clinical assessment but not a validated PD-specific prediction strategy; the post-discharge analysis reflects documented return to the index hospital rather than complete population-level readmission.

PMID:
42819128
Bibliographic data and abstract were imported from PubMed on 02 Oct 2026.

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