Schram Miranda T, Frijters Dinnus, van de Lisdonk Eloy H, Ploemacher Janneke, de Craen Anton J M, de Waal Margot W M, van Rooij Frank J, Heeringa Jan, Hofman Albert, Deeg Dorly J H, Schellevis Francois G
Extramural Medicine (EMGO Institute), VU University Medical Center, Amsterdam, The Netherlands.
J Clin Epidemiol. 2008 Nov;61(11):1104-12. doi: 10.1016/j.jclinepi.2007.11.021. Epub 2008 Jun 6.
The aim of the study was to investigate how settings and registry characteristics affect the prevalence and nature of multimorbidity in elderly individuals.
We used data from three population-based studies, two general practitioner registries, one hospital discharge register, and one nursing home registry to estimate the prevalence of multimorbidity. Individuals aged 55 years and over were included.
Multimorbidity was most prevalent in nursing homes (82%), followed by the general population and general practitioner registries (56%-72%) and the hospital setting (22%). There were large differences in the nature of multimorbidity between settings. Combinations of hypertension, heart disease, and osteoarthritis were dominant in the population-based setting, whereas hypertension in combination with osteoarthritis, obesity, disorders of lipid metabolism, and diabetes dominated in the general practitioner setting. In the hospital setting, combinations of heart diseases had the highest prevalence. Combinations of dementia, hypertension, and stroke were dominant within the nursing home setting.
This study shows that setting and registry characteristics have an important influence on the outcome of multimorbidity studies. We recommend provision of at least information about the setting, the (list of) conditions included, the data collection method, and the time frame used, when reporting about the size and nature of multimorbidity.
本研究旨在调查环境和登记处特征如何影响老年人共病的患病率及性质。
我们使用了来自三项基于人群的研究、两个全科医生登记处、一个医院出院登记处和一个养老院登记处的数据来估计共病的患病率。纳入了55岁及以上的个体。
共病在养老院中最为普遍(82%),其次是普通人群和全科医生登记处(56%-72%)以及医院环境(22%)。不同环境中共病的性质存在很大差异。在基于人群的环境中,高血压、心脏病和骨关节炎的组合占主导地位,而在全科医生环境中,高血压与骨关节炎、肥胖、脂质代谢紊乱和糖尿病的组合占主导地位。在医院环境中,心脏病的组合患病率最高。在养老院环境中,痴呆、高血压和中风的组合占主导地位。
本研究表明,环境和登记处特征对共病研究的结果有重要影响。我们建议在报告共病的规模和性质时,至少提供有关环境、所包括的疾病(列表)、数据收集方法和所用时间框架的信息。