TOPLINE

Deep brain stimulation (DBS) was associated with reduced risks for mortality and institutionalization, and lower healthcare costs in patients with Parkinson’s disease (PD), a study showed.

METHODOLOGY

• This retrospective cohort study involved 79,845 adults aged 50 years or older with a confirmed diagnosis of PD who were hospitalized in the US in 2018.
• Among them, 482 patients (0.6%) underwent DBS implantation during hospitalization (DBS group; mean age, 66.6 years; 67% men), and 79,363 patients (99.4%) did not (non-DBS group; mean age, 76.9 years; 59% men).
• Patients were followed for up to 5 years after discharge.
• The primary outcomes were hospital readmission, institutionalization (admission to a skilled nursing facility, intermediate care facility, or long-term care institution), all-cause mortality, and total medical costs, evaluated at 1, 3, and 5 years.

TAKEAWAY

• Readmission rates did not differ significantly between the DBS and non-DBS groups at any timepoint.
• DBS was independently associated with a significantly lower risk for institutionalization (adjusted odds ratio [aOR], 0.26, 0.25, and 0.27 at years 1, 3, and 5, respectively; P < .001 for all).
• The risk for death after discharge was significantly lower in the DBS vs non-DBS group at 1 year (aOR, 0.09; P = .028) and 5 years (aOR, 0.27; P = .023), suggesting a durable long-term survival advantage for patients who underwent DBS compared with those who did not.
• Mean weighted healthcare costs were significantly lower in the DBS vs non-DBS group at 1 year ($36,644 vs $50,543; P = .0012), 3 years ($45,310 vs $66,583; P < .001), and 5 years ($50,555 vs $74,469; P = .0006).

IN PRACTICE

“This nationwide real-world study suggests that DBS treatment is associated with more favorable long-term outcomes in survival, independence, and healthcare utilization,” the investigators wrote.

“Continued efforts to improve analytic precision and ensure equitable access will be important to better understand and optimize the role of DBS in routine clinical care,” they added.

SOURCE

The study was led by Hikaru Kamo, MD, PhD, Norman Fixel Institute for Neurological Diseases, University of Florida Health, Gainesville. It was published online on June 24 in npj Parkinson’s Disease.

LIMITATIONS

The study was limited by a retrospective observational design. Residual confounding, code-based misclassification, and the lack of PD-specific clinical measures may have influenced the results. The non-DBS cohort included many patients hospitalized for acute medical illness, whereas patients selected for DBS are generally healthier and have fewer surgical contraindications. Planned and unplanned readmissions could not be reliably separated, deaths occurring outside captured encounters may have been missed, and cost analyses were limited to patients with nonzero observed costs.

DISCLOSURES

The study was funded by the Japan Society for the Promotion of Science KAKENHI and the Parkinson’s Foundation Center of Excellence at the University of Florida. Disclosure information for the study investigators is available in the original study publication.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.