Postoperative Komplikationen bei Patienten mit Parkinson'scher Krankheit – Medizinische und ökonomische Aspekte

The demographic development with an increasing number of geriatric patients will result in a rising number of Parkinson's disease (PD) patients requiring surgery. To determine the impact of concomitant PD on the postoperative course we compared 27 patients with PD requiring general, visceral or thoracic surgery with 27 control patients using a matched-pairs approach; indication for surgery, operative treatment procedure, number of concomitant diseases, period of treatment, gender and age were used as matching parameters. PD patients showed an increased incidence of pneumonia and falls. Furthermore, the length of postoperative stay and ICU requirements were increased in this group, whereas control patients could be discharged more often for ambulatory rehabilitation. Compensation for PD patients compared to controls was considerably lower within the DRG-system and carried no advantage for PD patients. PD promotes the morbidity of surgical treatment procedures and demands increased resources, which are not reflected in the DRG system. Specific perioperative care to reduce conditional complications, sufficient ICU availability and need for stationary rehabilitation has to be considered in PD patients requiring surgery.