Patterns of multimorbidity in medical inpatients: a multinational retrospective cohort study

被引：0

作者：

Carole Elodie Aubert

Jeffrey Lawrence Schnipper

Niklaus Fankhauser

Pedro Marques-Vidal

Jérôme Stirnemann

Andrew David Auerbach

Eyal Zimlichman

Sunil Kripalani

Eduard Eric Vasilevskis

Edmondo Robinson

Joshua Metlay

Grant Selmer Fletcher

Andreas Limacher

Jacques Donzé

机构：

[1] Bern University Hospital,Department of General Internal Medicine, Inselspital

[2] University of Bern,Institute of Primary Health Care (BIHAM)

[3] University of Bern,Institute for Healthcare Policy and Innovation

[4] Veterans Affairs Center for Clinical Management Research,BWH Hospital Medicine Unit, Division of General Internal Medicine and Primary Care

[5] University of Michigan,Department of Internal Medicine

[6] Brigham and Women’s Hospital,Department of Internal Medicine

[7] Harvard Medical School,Division of Hospital Medicine

[8] CTU Bern,Section of Hospital Medicine, Division of General Internal Medicine and Public Health

[9] and Institute of Social and Preventive Medicine,Center for Clinical Quality and Implementation Research

[10] University of Bern,Section of Hospital Medicine

[11] Lausanne University Hospital,Geriatric Research Education and Clinical Center

[12] Geneva University Hospital,Division of General Internal Medicine

[13] University of California,Department of Medicine, Harborview Medical Center

[14] Sheba Medical Centre,Division of General Internal Medicine and Primary Care

[15] Vanderbilt University,Department of Internal Medicine

[16] Vanderbilt University,undefined

[17] Vanderbilt University Medical Center,undefined

[18] VA Tennessee Valley,undefined

[19] Christiana Care Health System,undefined

[20] Massachusetts General Hospital,undefined

[21] University of Washington,undefined

[22] Brigham and Women’s Hospital,undefined

[23] Hôpital neuchâtelois,undefined

来源：

Internal and Emergency Medicine | 2020年 / 15卷

关键词：

Multimorbidity; Patterns; Comorbidity; Chronic diseases;

D O I：

暂无

中图分类号：

学科分类号：

摘要：

Multimorbidity is frequent and represents a significant burden for patients and healthcare systems. However, there are limited data on the most common combinations of comorbidities in multimorbid patients. We aimed to describe and quantify the most common combinations of comorbidities in multimorbid medical inpatients. We used a large retrospective cohort of adults discharged from the medical department of 11 hospitals across 3 countries (USA, Switzerland, and Israel) between 2010 and 2011. Diseases were classified into acute versus chronic. Chronic diseases were grouped into clinically meaningful categories of comorbidities. We identified the most prevalent combinations of comorbidities and compared the observed and expected prevalence of the combinations. We assessed the distribution of acute and chronic diseases and the median number of body systems in relationship to the total number of diseases. Eighty-six percent (n = 126,828/147,806) of the patients were multimorbid (≥ 2 chronic diseases), with a median of five chronic diseases; 13% of the patients had ≥ 10 chronic diseases. Among the most frequent combinations of comorbidities, the most prevalent comorbidity was chronic heart disease. Other high prevalent comorbidities included mood disorders, arthropathy and arthritis, and esophageal disorders. The ratio of chronic versus acute diseases was approximately 2:1. Multimorbidity affected almost 90% of patients, with a median of five chronic diseases. Over 10% had ≥ 10 chronic diseases. This identification and quantification of frequent combinations of comorbidities among multimorbid medical inpatients may increase awareness of what should be taken into account when treating such patients, a growth in the need for special care considerations.

引用

页码：1207 / 1217

页数：10

共 179 条

[1] Diederichs C(2011)The measurement of multiple chronic diseases—a systematic review on existing multimorbidity indices J Gerontol Ser A Biol Sci Med Sci 66 301-311
[2] Berger K(2018)Defining and measuring multimorbidity: a systematic review of systematic reviews Eur J Pub Health 29 1-7
[3] Bartels DB(1996)Comorbidity or multimorbidity Eur J Gen Pract 2 65-70
[4] Johnston MC(2007)Multiple chronic conditions: prevalence, health consequences, and implications for quality, care management, and costs J Gen Intern Med 22 391-395
[5] Crilly M(2015)Multimorbidity, health care utilization and costs in an elderly community-dwelling population: a claims data based observational study BMC Health Serv Res 15 23-50
[6] Black C(2016)Health care utilization of patients with multiple chronic diseases in the Netherlands: differences and underlying factors Eur J Intern Med 35 44-266
[7] Prescott GJ(2014)Multimorbidity patterns: a systematic review J Clin Epidemiol 67 254-124
[8] Mercer SW(2012)Patterns of multimorbidity in primary care patients at high risk of future hospitalization Popul Health Manag 15 119-1005
[9] van den Akker M(2012)Comorbidity patterns in patients with chronic diseases in general practice PLoS ONE 7 e32141-660
[10] Buntinx F(2007)Multimorbidity clusters: clustering binary data from multimorbidity clusters: clustering binary data from a large administrative medical database App Multivar Res 12 163e82-e332

← 1 2 3 4 5 6 7 8 9 10 →