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  • Deep Brain Stimulation for Parkinson’s Disease at Pennsylvania Hospital: Survival Analysis with 10-year Follow-up

    Final Number:

    Ashwin G. Ramayya MD, PhD; Frederick Hitti MD; Brendan McShane BA; Kerry Alexandra Vaughan MD; Gordon H. Baltuch MD, PhD

    Study Design:
    Clinical Trial

    Subject Category:

    Meeting: Congress of Neurological Surgeons 2018 Annual Meeting

    Introduction: Deep Brain Stimulation (DBS) has been an established treatment for parkinson’s disease (PD) over the past 25 years, however, long-term outcomes associated with this procedure are poorly understood. Few studies have reported a series with follow-up of over 9 years, the largest of which examined a cohort of 79 patients (1). Here, we report long term sur-vival data in cohort of 200 patients with PD and at least 10 years followup.

    Methods: We conducted a retrospective review using administrative data for our patients who un-derwent DBS implantation for PD at our institution from January 1999 to June of 2006 with at least 10 years of follow-up (n = 200). We performed survival analyses using Kaplan Meier estimation and multivariate regression using Cox Proportional Hazards modeling.

    Results: Demographics for the cohort were as follows (n = 200): mean age of 63 years (median 64 years), 68% male, 26% patients had at least 1 medical co-morbidity (CAD, CHF, DM, atrial fibrillation, or DVT), and 78% had at least 1 revision surgery. At the end of 10 year follow-up, we observed a survival probability of 51% (mean age at death 73 years). Using multi-variate regression, we found that age at implantation (HR = 1.02, p = 0.01) and male gender (HR = 1.42, p = 0.02) were predictive of reduced survival, whereas increased survival was associated with increased number of revisions (HR = 0.36, p < 0.001). Number of medical co-morbidities was not significantly associated with survival, p > 0.5).

    Conclusions: We estimate a 10 year survival rate of 51% after initial DBS implantation for treatment of PD, which is similar to previous reports of long-term mortality in patients with non-surgically managed PD (54% survival at 9.6 years of disease (2)).

    Patient Care: To our knowledge, our research is the largest analysis of long term follow up in DBS patients after 10 years.

    Learning Objectives: By the conclusion of this session, participants should be able to better understand the long term history of patients being treated with DBS for movement disorders.

    References: (1) Bang Henriksen, M., et al. "Surviving 10 years with deep brain stimulation for Parkinson's disease–a follow-up of 79 patients." European journal of neurology 23.1 (2016): 53-61. (2) Hely, M. A., Morris, J. G., Traficante, R., Reid, W. G., O’Sullivan, D. J., & Williamson, P. M. (1999). The Sydney multicentre study of Parkinson’s disease: progression and mortality at 10 years. Journal of Neurology, Neurosurgery & Psychiatry, 67(3), 300-307.

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