Journal
EUROPEAN JOURNAL OF INTERNAL MEDICINE
Volume 27, Issue -, Pages 68-75Publisher
ELSEVIER
DOI: 10.1016/j.ejim.2015.09.021
Keywords
Multimorbidity; Comorbidity; Hospitalization; Older adults; Internal medicine
Categories
Funding
- Netherlands Organization of Health Research and Development [13550004]
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Background: To describe the prevalence of multimorbidity and to study the association between acute and chronic diseases in acutely hospitalized older patients Methods: Prospective cohort study conducted between 2006 and 2008 in three teaching hospitals in the Netherlands. 639 patients aged 65 years and older, hospitalized for >48 h were included. Two physicians scored diseases, using ICD-9 codes. Chronic multimorbidity was defined as the presence of >= 2 chronic diseases, and acute multimorbidity as >= 1 acute diseases upon pre-existent chronic diseases. Logistic regression analyses were conducted to analyse cluster associations between a chronic index disease and the concurrent chronic or acute disease, corrected for age and sex. Results: The mean age of patients was 78 years, over 50% had ADL impairments. Prevalence of chronic multimorbidity was 69%, and acute multimorbidity was present in 88%. Hypertension (OR 1.16; 95% CI 1.08-1.24), diabetes (type I or type 2) (OR 1.12; 95% CI 1.04-1.21), heart failure (OR 1.25; 95% CI 1.14-1.38) and COPD (OR 1.19; 95% CI 1.05-1.34) were associated with acute renal failure. Hypertension (OR 1.10; 95% CI 1.04-1.17) and atrial fibrillation (OR 1.17; 95% CI 1.08-1.27) were associated with an adverse drug event. Gastro-intestinal bleeding was clustered with atrial fibrillation (OR 1.11; 95% CI 1.04-1.19) and gastric ulcer (OR 1.16; 95% CI 1.07-1.25). Conclusion: Both acute and chronic multimorbidity was frequently present in hospitalized older patients. We identified specific associations between acute and chronic diseases. There is a need for strategies addressing multimorbidity during the exacerbation of chronic diseases. (C) 2015 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.
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