1. Scorza, Fulvio A.
  2. de Almeida, Antonio-Carlos G.
  3. Fiorini, Ana C.
  4. Scorza, Carla A.
  5. Finsterer, Josef

Article Content

Parkinson disease (PD) requires 1.5 times more likely hospitalization than controls.1 Duration of hospitalization and rate of complications are increased in PD patients.1 Inpatients with PD may have a higher mortality rate than outpatients with PD.1 In a recent article entitled "Hospital Magnet Status Associates With Inpatient Safety in Parkinson Disease," by Aamodt and colleagues,2 the authors showed that PD patients had a reduced risk of inpatient mortality and several nursing-sensitive patient safety events, highlighting the benefits of Magnet status on inpatient safety in PD.2 Magnet status is associated with better nursing, patient, and organizational outcomes, as well as better nursing work environments, than non-Magnet status.3 Therefore, the question is: what are the effects of Magnet status on cardiac events in PD?


Parkinson disease is one of the most frequent age-related neurodegenerative disorders, affects millions of people globally, and has no cure, and several studies have demonstrated that patients with PD have a higher risk of mortality.4 The predominant causes of death in PD are related to pneumonia and cardiovascular diseases.4 Sudden unexpected death in PD (SUDPAR), a rare but fatal event, is increasingly discussed as a contributor to mortality in PD.4 The exact etiology of SUDPAR is unknown, but a combination of cardiac abnormalities and autonomic dysfunction is thought to underlie SUDPAR.4 SUDPAR likely arises from a combination and interaction of multiple risk factors, such as age at onset, duration of PD, sex, motor severity, and drug treatment (polypharmacy).4 Considering these clinical aspects, the question remains how to implement these findings about SUDPAR.


As several studies reported better outcomes in Magnet hospitals2,3 than in non-Magnet hospitals, increasing awareness of SUDPAR among multidisciplinary team members and the community allows improved patient and family counseling and, possibly, modification of risk factors. In fact, a fundamental practical problem in studying SUDPAR risk factors, mechanisms, and prevention is that it is relatively uncommon.4 Crucial questions are whether and when to talk about SUDPAR to individuals and family members. Thus, it would be appropriate to establish a task force that discusses issues related to SUDPAR. A close convergence of clinicians, nurses, and scientists is important to assess and establish the state of knowledge about SUDPAR.4 Another point is the importance of focusing also on diet and food preferences of PD patients, as well as facts related to the prevention of possible cases of SUDPAR.4 In view of the complex needs of PD patients, an interesting study verified the reason for admission, specialist team interventions, length of stay, frequency of readmission, discharge destination, mortality, and the bed cost per unplanned emergency department attendance or hospital admission episode.5 The results reported in this study support previous findings, where similar patterns of admission to hospital showed mortality rates higher than expected.5


PD is a systemic neurodegenerative disorder. Importantly, the increase in the mortality rate in PD and the occurrence of SUDPAR cases are facts and should be carefully investigated by neuroscientists. Finally, we are convinced that Magnet status will allow nurses to be actively involved in SUDPAR issues.




1. Lance S, Travers J, Bourke D. Reducing medication errors for hospital inpatients with Parkinsonism. Intern Med J. 2021;51(3):385-389. [Context Link]


2. Aamodt WW, Travers J, Thibault D, Willis AW. Hospital Magnet status associates with inpatient safety in Parkinson disease. J Neurosci Nurs. 2021;53(3):116-122. [Context Link]


3. Rodriguez-Garcia MC, Marquez-Hernandez VV, Belmonte-Garcia T, Gutierrez-Puertas L, Granados-Gamez G. Original research: how Magnet hospital status affects nurses, patients, and organizations: a systematic review. Am J Nurs. 2020;120(7):28-38. [Context Link]


4. Menezes-Rodrigues FS, Scorza CS, Fiorini AC, et al. Sudden unexpected death in Parkinson's disease: why is drinking water important?Neurodegener Dis Manag. 2019;9(4):241-246. [Context Link]


5. Hobson P, Roberts S, Davies G. The introduction of a Parkinson's disease email alert system to allow for early specialist team review of inpatients. BMC Health Serv Res. 2019;19(1):271. [Context Link]