Management of acute situations in institutionalised Parkinsonian patients: A survey in Seine-Saint-Denis, France - 01/11/26

Doi : 10.1016/j.neurol.2026.10.003

L. Braccagni ^a, S. Coudin ^b, B. Degos ^a,^c,⁎ , M. Houot ^d,^e,^f

^a Service de neurologie, AP–HP, Hôpital Avicenne, Hôpitaux Universitaires de Paris-Seine-Saint-Denis, Sorbonne Paris Nord, Bobigny, France

^b Homeperf, Île-de-France, Gennevilliers, France

^c Dynamics and Pathophysiology of Neuronal Networks Team, Center for Interdisciplinary Research in Biology, Collège de France, CNRS UMR7241/Inserm U1050, Université PSL, 75005 Paris, France

^d Center of Excellence of Neurodegenerative Disease (CoEN), AP–HP, Pitié-Salpêtrière Hospital, Paris, France

^e Clinical Investigation Centre (CIC) Neuroscience, Paris Brain Institute, Pitié-Salpêtrière Hospital, Paris, France

^f Department of Neurology, Institute of Memory and Alzheimer's Disease (IM2A), AP–HP, Pitié-Salpêtrière Hospital, Paris, France

^⁎ Corresponding author at: Service de Neurologie, AP–HP, hôpital Avicenne, hôpitaux universitaires de Paris-Seine-Saint-Denis, Sorbonne Paris Nord, Bobigny, France. Service de Neurologie, AP–HP, hôpital Avicenne, hôpitaux universitaires de Paris-Seine-Saint-Denis, Sorbonne Paris Nord Bobigny France

Sous presse. Épreuves corrigées par l'auteur. Disponible en ligne depuis le Sunday 01 November 2026

Abstract

Objective

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.

Methods

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.

Results

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).

Conclusion

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.

Le texte complet de cet article est disponible en PDF.

Keywords : Parkinson's disease, Parkinsonian syndrome, EHPAD, Emergency department, Ageing