Delirium and high fever are associated with subacute motor deterioration in Parkinson disease: a nested case-control study.

<h4>Background</h4>In Parkinson disease (PD), systemic inflammation caused by respiratory infections such as pneumonia frequently occurs, often resulting in delirium in the advanced stages of this disease. Delirium can lead to cognitive and functional decline, institutionalization, and m...

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Autores principales:	Atsushi Umemura, Tomoko Oeda, Satoshi Tomita, Ryutaro Hayashi, Masayuki Kohsaka, Kwiyoung Park, Hiroshi Sugiyama, Hideyuki Sawada
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2014
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/72e324dccaf243a89b49744fff3695c5
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spelling	oai:doaj.org-article:72e324dccaf243a89b49744fff3695c52021-11-18T08:17:30ZDelirium and high fever are associated with subacute motor deterioration in Parkinson disease: a nested case-control study.1932-620310.1371/journal.pone.0094944https://doaj.org/article/72e324dccaf243a89b49744fff3695c52014-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/24887491/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background</h4>In Parkinson disease (PD), systemic inflammation caused by respiratory infections such as pneumonia frequently occurs, often resulting in delirium in the advanced stages of this disease. Delirium can lead to cognitive and functional decline, institutionalization, and mortality, especially in the elderly. Inflammation causes rapid worsening of PD motor symptoms and signs, sometimes irreversibly in some, but not all, patients.<h4>Purpose</h4>To identify factors associated with subacute motor deterioration in PD patients with systemic inflammation.<h4>Methods</h4>The association of clinical factors with subacute motor deterioration was analyzed by a case-control study. Subacute motor deterioration was defined as sustained worsening by one or more modified Hoehn and Yahr (H-Y) stages. Using multivariable logistic regression incorporating baseline characteristics (age, sex, PD duration, modified H-Y stage, dementia, and psychosis history) and statistically selected possible predictors (peak body temperature, duration of leukocytosis, and presence of delirium), the odds ratios for these factors were estimated as relative risks.<h4>Results</h4>Of 80 PD patients with systemic inflammation, 26 with associated subacute motor deterioration were designated as cases and the remainder as controls. In the 26 cases, 6 months after its onset the motor deterioration had persisted in 19 patients and resolved in four (three were lost for follow-up). Multivariable logistic regression analysis showed that delirium and body temperature are significantly associated with motor deterioration after systemic inflammation (P = 0.001 for delirium and P = 0.026 for body temperature), the adjusted odds ratios being 15.89 (95% confidence interval [CI]: 3.23-78.14) and 2.78 (95% CI: 1.13-6.83), respectively.<h4>Conclusions</h4>In patients with PD and systemic inflammation, delirium and high body temperature are strong risk factors for subsequent subacute motor deterioration and such deterioration can persist for over 6 months.Atsushi UmemuraTomoko OedaSatoshi TomitaRyutaro HayashiMasayuki KohsakaKwiyoung ParkHiroshi SugiyamaHideyuki SawadaPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 9, Iss 6, p e94944 (2014)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Atsushi Umemura Tomoko Oeda Satoshi Tomita Ryutaro Hayashi Masayuki Kohsaka Kwiyoung Park Hiroshi Sugiyama Hideyuki Sawada Delirium and high fever are associated with subacute motor deterioration in Parkinson disease: a nested case-control study.
description	<h4>Background</h4>In Parkinson disease (PD), systemic inflammation caused by respiratory infections such as pneumonia frequently occurs, often resulting in delirium in the advanced stages of this disease. Delirium can lead to cognitive and functional decline, institutionalization, and mortality, especially in the elderly. Inflammation causes rapid worsening of PD motor symptoms and signs, sometimes irreversibly in some, but not all, patients.<h4>Purpose</h4>To identify factors associated with subacute motor deterioration in PD patients with systemic inflammation.<h4>Methods</h4>The association of clinical factors with subacute motor deterioration was analyzed by a case-control study. Subacute motor deterioration was defined as sustained worsening by one or more modified Hoehn and Yahr (H-Y) stages. Using multivariable logistic regression incorporating baseline characteristics (age, sex, PD duration, modified H-Y stage, dementia, and psychosis history) and statistically selected possible predictors (peak body temperature, duration of leukocytosis, and presence of delirium), the odds ratios for these factors were estimated as relative risks.<h4>Results</h4>Of 80 PD patients with systemic inflammation, 26 with associated subacute motor deterioration were designated as cases and the remainder as controls. In the 26 cases, 6 months after its onset the motor deterioration had persisted in 19 patients and resolved in four (three were lost for follow-up). Multivariable logistic regression analysis showed that delirium and body temperature are significantly associated with motor deterioration after systemic inflammation (P = 0.001 for delirium and P = 0.026 for body temperature), the adjusted odds ratios being 15.89 (95% confidence interval [CI]: 3.23-78.14) and 2.78 (95% CI: 1.13-6.83), respectively.<h4>Conclusions</h4>In patients with PD and systemic inflammation, delirium and high body temperature are strong risk factors for subsequent subacute motor deterioration and such deterioration can persist for over 6 months.
format	article
author	Atsushi Umemura Tomoko Oeda Satoshi Tomita Ryutaro Hayashi Masayuki Kohsaka Kwiyoung Park Hiroshi Sugiyama Hideyuki Sawada
author_facet	Atsushi Umemura Tomoko Oeda Satoshi Tomita Ryutaro Hayashi Masayuki Kohsaka Kwiyoung Park Hiroshi Sugiyama Hideyuki Sawada
author_sort	Atsushi Umemura
title	Delirium and high fever are associated with subacute motor deterioration in Parkinson disease: a nested case-control study.
title_short	Delirium and high fever are associated with subacute motor deterioration in Parkinson disease: a nested case-control study.
title_full	Delirium and high fever are associated with subacute motor deterioration in Parkinson disease: a nested case-control study.
title_fullStr	Delirium and high fever are associated with subacute motor deterioration in Parkinson disease: a nested case-control study.
title_full_unstemmed	Delirium and high fever are associated with subacute motor deterioration in Parkinson disease: a nested case-control study.
title_sort	delirium and high fever are associated with subacute motor deterioration in parkinson disease: a nested case-control study.
publisher	Public Library of Science (PLoS)
publishDate	2014
url	https://doaj.org/article/72e324dccaf243a89b49744fff3695c5
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Delirium and high fever are associated with subacute motor deterioration in Parkinson disease: a nested case-control study.

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