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50 岁及以上成年人和老年人的多种共病模式和住院发生情况。

Multimorbidity patterns and hospitalisation occurrence in adults and older adults aged 50 years or over.

机构信息

Postgraduate Program in Health Sciences, Faculty of Medicine, Federal University of Goiás, Goiânia, 74605-050, Brazil.

Duke Global Health Institute, Duke University, Durham, NC, USA.

出版信息

Sci Rep. 2022 Jul 8;12(1):11643. doi: 10.1038/s41598-022-15723-4.


DOI:10.1038/s41598-022-15723-4
PMID:35804008
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9270321/
Abstract

Multimorbidity is highly prevalent in older adults and can lead to hospitalisation. We investigate the prevalence, associated factors, and multimorbidity pattern associated to hospitalisation, readmission, and length of stay in the population aged 50 years and older. We analysed baseline data (2015-2016) from the ELSI-Brazil cohort, a representative sample of non-institutionalised Brazilians aged ≥ 50 years. In total, 8807 individuals aged ≥ 50 years were included. Poisson regression with robust variance adjusted for confounders was used to verify the associations with hospitalisation. Multiple linear regression was used to analyse the associations with readmission and length of stay. Network analysis was conducted using 19 morbidities and the outcome variables. In 8807 participants, the prevalence of hospitalisation was 10.0% (95% CI 9.1, 11), mean readmissions was 1.55 ± 1.191, and mean length of stay was 6.43 ± 10.46 days. Hospitalisation was positively associated with male gender, not living with a partner, not having ingested alcoholic beverages in the last month, and multimorbidity. For hospital readmission, only multimorbidity ≥ 3 chronic conditions showed a statistically significant association. Regarding the length of stay, the risk was positive for males and negative for living in rural areas. Five disease groups connected to hospitalisation, readmission and length of stay were identified. To conclude, sociodemographic variables, such as gender, age group, and living in urban areas, and multimorbidity increased the risk of hospitalisation, mean number of readmissions, and mean length of stay. Through network analysis, we identified the groups of diseases that increased the risk of hospitalisation, readmissions, and length of stay.

摘要

多发病在老年人中非常普遍,可能导致住院。我们研究了≥50 岁人群中发病率、相关因素以及与住院、再入院和住院时间相关的多发病模式。我们分析了 ELSI-Brazil 队列的基线数据(2015-2016 年),该队列是≥50 岁非住院巴西人的代表性样本。共纳入 8807 名≥50 岁的个体。使用调整混杂因素的稳健方差的泊松回归来验证与住院的相关性。使用多元线性回归分析与再入院和住院时间的相关性。使用 19 种疾病和结局变量进行网络分析。在 8807 名参与者中,住院率为 10.0%(95%CI 9.1,11),平均再入院率为 1.55±1.191,平均住院时间为 6.43±10.46 天。住院与男性、与伴侣同住、最近一个月未饮酒以及多发病显著相关。对于住院再入院,仅≥3 种慢性疾病与住院再入院显著相关。关于住院时间,男性的风险呈阳性,而农村地区的风险呈阴性。确定了与住院、再入院和住院时间相关的五个疾病组。总之,社会人口学变量,如性别、年龄组和居住在城市地区,以及多发病增加了住院、再入院和平均住院时间的风险。通过网络分析,我们确定了增加住院、再入院和住院时间风险的疾病组。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/71a2/9270321/ece9dd808b79/41598_2022_15723_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/71a2/9270321/ece9dd808b79/41598_2022_15723_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/71a2/9270321/ece9dd808b79/41598_2022_15723_Fig1_HTML.jpg

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Multimorbidity patterns and hospitalisation occurrence in adults and older adults aged 50 years or over.

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[6]
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[7]
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[8]
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[10]
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本文引用的文献

[1]
Who are the people with Alzheimer's disease in Brazil? Findings from the Brazilian Longitudinal Study of Aging.

Rev Bras Epidemiol. 2021

[2]
Family Health Strategy, Primary Health Care, and Social Inequalities in Mortality Among Older Adults in Bagé, Southern Brazil.

Am J Public Health. 2021-5

[3]
Multimorbidity and its associated factors among adults aged 50 and over: A cross-sectional study in 17 European countries.

PLoS One. 2021-2-11

[4]
Multimorbidity Patterns and Unplanned Hospitalisation in a Cohort of Older Adults.

J Clin Med. 2020-12-10

[5]
Examining multimorbidity differences across racial groups: a network analysis of electronic medical records.

Sci Rep. 2020-8-11

[6]
Investigation of multimorbidity and prevalent disease combinations in older Irish adults using network analysis and association rules.

Sci Rep. 2019-10-10

[7]
Prevalence of multimorbidity in community settings: A systematic review and meta-analysis of observational studies.

J Comorb. 2019-8-22

[8]
Multimorbidity and Hospital Admissions in High-Need, High-Cost Elderly Patients.

J Aging Health. 2020

[9]
Hospitalizations among older adults: results from ELSI-Brazil.

Rev Saude Publica. 2018-10-25

[10]
Multimorbidity: The Brazilian Longitudinal Study of Aging (ELSI-Brazil).

Rev Saude Publica. 2018-10-25

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