Management of acute situations in institutionalised Parkinsonian patients: A survey in Seine-Saint-Denis, France.

Authors

L Braccagni, S Coudin, B Degos, M Houot

Published in

Revue neurologique. Oct 31, 2026. Epub Oct 31, 2026.

Abstract

Patients with Parkinson's disease (PD) or atypical parkinsonian syndromes (PS) living in long-term care facilities face complex medical needs, yet little is known about their medical follow-up and reasons for emergency department referrals and hospitalisations in this setting. This study aimed to describe the prevalence of PD/PS among residents of long-term care facilities (EHPADs) in the French Seine-Saint-Denis department, their medical follow-up, and the frequency and reasons for emergency department referrals and hospitalisations.
This retrospective study covered the year 2023. All 66 EHPADs in the department were contacted to complete a facility-level questionnaire on PD/PS prevalence and emergency referrals. Facilities with PD/PS residents were then invited to complete a patient-level questionnaire collecting demographic, clinical and follow-up data, and details regarding emergency referrals and hospitalisations.
Thirty-five EHPADs (53%) responded, representing 3398 residents. Thirty facilities reported 144 residents with PD or PS, corresponding to a prevalence of 4.24% [95% CI: 3.60-4.98%]. Sixteen (53.3%) EHPADs reported at least one PD/PS resident referred to the emergency department, resulting in 62 referrals during the year, corresponding to an incidence rate of 0.43 [95% CI: 0.33-0.55] referrals per PD/PS resident-year. Eight EHPADs (26.7%) completed the patient-level questionnaire, providing data on 34 residents (median [Q1-Q3] age: 80 [75-85], 73.5% with PD). Over one-third (38.2%) did not have a designated neurologist during 2023. Nine patients (27.3%) were referred to the emergency department, mainly for axial disorders (33.3%) and infections (33.3%). Nine patients (26.5%) were hospitalised. Exploratory analyses showed that hospitalisation was significantly associated with emergency referral (P=0.02) and a last general practitioner consultation that was less often for routine care (P=0.048).
PD and PS were frequently identified among residents of participating EHPADs, yet a substantial proportion of patients lack neurological follow-up. Emergency referrals and hospitalisations affected approximately one-quarter of patients, often for potentially preventable causes. These findings suggest that preventive strategies, multidisciplinary follow-up, and improved access to neurologists may help reduce avoidable hospitalisations.

PMID:
42966679
Bibliographic data and abstract were imported from PubMed on 01 Nov 2026.

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