Chronic diseases spectrum and multimorbidity in elderly inpatients based on a 12-year epidemiological survey in China

BMC Public Health, Journal Year: 2024, Volume and Issue: 24(1)

Published: Feb. 17, 2024

Abstract Background The number and proportion of the elderly population have been continuously increasing in China, leading to elevated prevalence chronic diseases multimorbidity, which ultimately brings heavy burden society families. Meanwhile, status multimorbidity tends be more complex inpatients than community population. In view above concerns, this study was designed investigate health by analyzing clinical data Chinese People's Liberation Army (PLA) General Hospital from 2008 2019, including constitution common diseases, comorbidities, in-hospital death polypharmacy among inpatients, so as better understand spectrum also provide supporting evidence for targeted management elderly. Methods A database set up collecting medical records 2019 PLA Hospital, focusing on characteristics inpatients. study, we collected aged ≥ 65 years old, further analyzed rates mortality causes past decade. addition, prescriptions were Results total 210,169 patients hospitalized January 1st, December 31st, 2019. corresponding hospitalizations 290,833. average age 72.67 old. Of population, 73,493 re-admitted within one year, with re-hospitalization rate 25.27%. Malignant tumor, hypertension, ischemic heart disease, diabetes mellitus cerebrovascular disease top 5 diseases. Among two or long-term conditions 267,259, accounting 91.89%, an 4.68 medications taken 5.4, which, taking types accounted 55.42%. Conclusions By found that has turned out a prominent problem greatly affecting process healthy aging families society. Therefore, multidisciplinary treatment should strengthened make reasonable preventive therapeutic strategies improve life quality attention paid avoid preventable side effects caused irrational medication therapy.

Language: Английский

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Experienced-based co-design for cardiovascular and chronic disease research

European Journal of Cardiovascular Nursing, Journal Year: 2025, Volume and Issue: unknown

Published: Jan. 2, 2025

Abstract The participatory co-design method has received significant attention recently. Experience-based is an approach that enables patients (service users) and healthcare providers delivers) to services care pathways in partnership improve health outcomes based on their experience. Traditionally, it was used as a quality improvement technique. Yet, valuable research design can help be applied nursing research. This paper will discuss its application among people living with cardiovascular multimorbidity practicalities, usability, impact chronic disease models of care.

Language: Английский

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Reporting and representation of underserved groups in intervention studies for patients with multiple long-term conditions: a systematic review

Journal of the Royal Society of Medicine, Journal Year: 2024, Volume and Issue: 117(9), P. 302 - 317

Published: April 16, 2024

Objectives Globally, there is a growing number of people who are living with multiple long-term conditions (MLTCs). Due to complex management needs, it imperative that research consists participants may benefit most from interventions. It well documented ethnic minority groups and lower socioeconomic status (SES) at an increased risk developing MLTCs. Therefore, the aim this systematic review was determine level reporting representation underserved (ethnic low SES) in intervention studies addressing Design Systematic review. Four databases including Cochrane Library, MEDLINE, CINAHL Scopus were searched for North America or Europe published between January 1990 July 2023. Setting Hospital community-based We included interventional focusing on improving MLTC-related outcomes. Participants Patients Main outcome measures Total ethnicity SES. Number proportion by ethnic/SES group. Results Thirteen met inclusion criteria. Only 4 13 (31%) recorded reported information. Of these four ethnicity, three consisted primarily White participants. Ethnic underrepresented, but one study majority African American Moreover, 12 (92%) SES income educational being primary used. higher deprivation varied due limited data. Conclusions For lack reporting, underrepresented studies. SES, high samples across spectrum variety Findings highlight need improve provide more detailed information through using consistent (e.g. education, employment) accurately distribution

Language: Английский

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Spatial Analysis of patterns of Multimorbidity in the Thai Cohort Study Using Latent Class Analysis

Journal of Epidemiology and Global Health, Journal Year: 2025, Volume and Issue: 15(1)

Published: Feb. 12, 2025

Language: Английский

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Clusters and associations of adverse neonatal events with adult risk of multimorbidity: A secondary analysis of birth cohort data

PLoS ONE, Journal Year: 2025, Volume and Issue: 20(3), P. e0319200 - e0319200

Published: March 18, 2025

Objective To investigate associations between clustered adverse neonatal events and later-life multimorbidity. Design Secondary analysis of birth cohort data. Setting Prospective study individuals born in Britain one week 1970. Population Respondents provided data at (n = 17,196), age 34 11,261), 38 9,665), 42 9,840), 46 8,580). Methods Mixed components determined included factors, ‘Birthweight’; ‘Neonatal cyanosis’; cerebral signs’; illnesses’; breathing difficulties’; ‘Prolonged duration to establishment respiratory rate birth’, within the composite event score. Log-binomial regression quantified unadjusted covariate-adjusted (paternal employment status social class; maternal smoking status; age; parity; member Body Mass Index) score risk multimorbidity adulthood. Outcome measures Multimorbidity each adult sweep, defined as presence two or more Long-Term Conditions (LTCs). Results 13.7% respondents experienced event(s) birth. The percentage reporting increased steadily from 14.6% 25.5% 46. A significant association was only observed years sweep; those who had a 41.0% (95% CI: 1.05 – 1.88) multimorbidity, compared not suffered any This maintained following adjustment for parental confounders status. Conclusions Adverse may be independently associated with development midlife Programmes policies aimed tackling growing public health burden also need consider interventions reduce

Language: Английский

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Risk prediction models for mortality in patients with multimorbidity: a systematic review and meta-analysis

Frontiers in Public Health, Journal Year: 2025, Volume and Issue: 13

Published: April 2, 2025

Multimorbidity is a major aging and public health problem that has significant burden on global scale. The number of risk prediction models for mortality in patients with multimorbidity increasing; however, the quality applicability these clinical practice future research remain uncertain. To systematically review published studies multimorbidity. Wanfang, China National Knowledge Infrastructure, Science Technology Journal (VIP), PubMed, SinoMed, Cochrane Library, Web Science, Embase, Cumulative Index to Nursing Allied Health Literature databases were searched from inception until May 30, 2024. Two independent reviewers performed study selection, data extraction, assessment. Prediction Model Risk Bias Assessment Tool (PROBAST) checklist was utilized assess bias applicability. Overall, 18 21 included this review. Logistic regression used model development 12 studies, Cox four, parametric Weibull one, machine learning one study. incidence ranged 7.6-50.0%. most frequently predictors age body mass index. reported area under receiver operating characteristic curve (AUC) C-index values 0.700-0.907. Three rated as having low bias, 11 high, four unclear, primarily owing poor reporting analysis domain. pooled AUC value seven validated 0.81, 95% confidence interval ranging 0.77-0.86, signifying fair level discrimination. revealed degree discriminatory ability predicting multimorbidity; they all demonstrated risks based PROBAST Future researchers should prioritize new incorporate rigorous designs multicenter external validation, which may improve precision predictions help strategies problem. protocol registered PROSPERO (registration number: CRD42024543170). https://www.crd.york.ac.uk/PROSPERO/recorddashboard, CRD42024543170.

Language: Английский

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Multiple Long‐Term Conditions, Co‐Long‐Term Conditions and Polyvascular Disease: Considerations for Evidence Synthesis and Meta‐Analyses

Cochrane Evidence Synthesis and Methods, Journal Year: 2025, Volume and Issue: 3(3)

Published: April 3, 2025

Abstract Cochrane's scientific strategy for 2025 to 2030 has four research priorities, including improving the lives of people living with multiple chronic conditions. The purpose this article written by Cochrane Thematic Group in Heart, Stroke and Circulation is explore considerations around conditions (also referred as ‘multiple long‐term conditions’ i.e. two or more conditions) systematic reviews. Rather than using term ‘comorbidity’, we introduce a new ‘co‐long‐term conditions’. We also how define ‘polyvascular disease’. suggest that review authors consider co‐long‐term their reviews e.g. extract data about primary studies address conditions, perform subgroup analyses according presence not include section discussion well participants were represented studies. This especially pertinent addressing heart, circulatory stroke disease, polyvascular disease.

Language: Английский

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Multimorbidity and risk of dementia: A systematic review and meta-analysis of longitudinal cohort studies

The Journal of Prevention of Alzheimer s Disease, Journal Year: 2025, Volume and Issue: unknown, P. 100164 - 100164

Published: April 1, 2025

Language: Английский

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The Effect of Coordinating the Outpatient Treatment across Medical Specialities for Patients With Multimorbidity

International Journal of Integrated Care, Journal Year: 2024, Volume and Issue: 24, P. 4 - 4

Published: April 9, 2024

Introduction: Patients with multimorbidity attend multiple outpatient clinics. We assessed the effects on hospital use of scheduling several appointments to same-day visits in a multidisciplinary pathway (MOP). Methods: This study used quasi-experimental design. Eligible patients had multimorbidity, were aged ≥18 years and attended ≥2 clinics five different specialties. identified through forthcoming from August 2018 March 2020 divided into intervention group (alignment appointments) comparison (no alignment). patient questionnaires paired analyses care integration treatment burden. Using negative binomial regression, we estimated healthcare utilisation as incidence rates ratios (IRRs) at one year before after baseline for both groups compared IRR (IRRRs). Results: Intervention 19% reduction (IRRR: 0.81, 95% CI: 0.70–0.96) 17% blood samples 0.83, 0.73–0.96) patients. No found integration, burden, contacts, terminated trajectories, admissions, days admission or GP contacts. Conclusion: The MOP seemed reduce number samples. These results should be further investigated studies exploring coordination multimorbidity. Research question: Can an coordinating combined conference influence services patient-assessed burden among multimorbidity?

Language: Английский

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Interactions between patterns of multimorbidity and functional status among hospitalized older patients: a novel approach using cluster analysis and association rule mining

Journal of Translational Medicine, Journal Year: 2024, Volume and Issue: 22(1)

Published: July 18, 2024

Abstract Background Multimorbidity (MM) is generally defined as the presence of 2 or more chronic diseases in same patient and seems to be frequently associated with frailty poor quality life. However, complex interplay between MM functional status hospitalized older patients has not been fully elucidated so far. Here, we implemented a 2-step approach, combining cluster analysis association rule mining explore how patterns disease associations change function disability. Methods This retrospective cohort study included 3366 discharged from acute care units Ancona Cosenza sites Italian National Institute on Aging (INRCA-IRCCS) 2011 2017. Cluster (ARM) were used whole population after stratifying by dependency activities daily living (ADL) at discharge. Sensitivity analyses men women conducted test for robustness findings. Results Out patients, 78% multimorbid. According status, 22.2% had no disability ADL (functionally independent group), 22.7% 1 (mildly dependent 57.4% impaired (moderately-severely group). Two main clusters identified general single groups. ARM revealed interesting within-cluster associations, characterized high lift confidence. Specifically, functionally group, most significant ones involved atrial fibrillation (AF)-anemia kidney (CKD) (lift = 2.32), followed coronary artery (CAD)-AF heart failure (HF) 2.29); moderate-severe disability, CAD-HF AF 1.97), thyroid dysfunction 1.75), cerebrovascular (CVD)-CAD 1.55), hypertension-anemia CKD 1.43). Conclusions Hospitalized have rates impairment. Combining may assist physicians discovering unexpected different status. could relevant view individuating personalized diagnostic therapeutic approaches, according modern principles precision medicine.

Language: Английский

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