Introduction and Objectives: Pneumonia, an emerging burden to patients with Parkinson disease (PD), is known as the leading cause of death and the most common reason for hospital admission in PD patients. However, virtually nothing is known regarding the incidence of pneumonia in patients with PD. Therefore, we conducted the population-based study to explore the incidence and risk factors of pneumonia in patients with PD.
Methods: Using the National Health Insurance Service database covering the entire Korean population from 2002 to 2017, we identified incident PD patients in 2004–2006, and selected 4 age- and sex-matched controls to each PD patient. We included PD patients according to registration code in the program for rare, intractable disease for PD (V124). We identified the occurrence of pneumonia and assess the risk factors of pneumonia in these matched cohort throughout the study period to 2017.
Results: We identified 10159 incident PD patient and matched 39574 controls. During the 14-year study period (2004–2017), the incidence rate was higher in the PD patients than the matched-controls (11.21 vs 3.61 events per 1,000 person-year). Within 5 years after the index date, 15.05% of patients with PD and 6.27% of patients in control group experienced pneumonia and 32.29% of patients with PD and 15.91% of patients in control group experienced pneumonia within 10 years after the index date. After adjusting confounders, PD patients had an increased risk of pneumonia (hazard ratio = 2.264; 95% CI, 2.17–2.36). Older age, men, region of residence, diabetes mellitus, congestive heart failure, cancer, tuberculosis, atrial fibrillation, chronic kidney disease, cerebrovascular disease, dementia, COPD and seizure disorder were associated with higher risk of pneumonia. Age was the strongest risk factor of pneumonia (in group older than 70 years; HR 6.517, 95% CI 5.895-7.204). Hypertension and dyslipidemia were a protective factor for pneumonia (for hypertension, HR 0.95, 95% CI 0.908-0.993; for dyslipidemia, HR 0.805, 95% CI 0.765-0.846).
Conclusions: Through using a nationwide population-based database which includes entire 48 million individuals in the single country, this study revealed that PD patient were more likely to experience pneumonia than the general population, even after considering other confounders. The pneumonia incidence at each period over 10 years from diagnosis and identified risk factors will help to assess the risk of pneumonia and implement proper preventive measures in patients with PD. |
