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Acute and chronic diseases as part of multimorbidity in acutely hospitalized older patients.
Eur J Intern Med. 2015 Oct 14;
Authors: Buurman BM, Frenkel WJ, Abu-Hanna A, Parlevliet JL, de Rooij SE
Abstract
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 65years and older, hospitalized for >48h 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 78years, 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.
PMID: 26477016 [PubMed - as supplied by publisher]