Multimorbidity Patterns and Unplanned Hospitalisation in a Cohort of Older Adults

Abstract

The presence of multiple chronic conditions (i.e., multimorbidity) increases the risk of hospitalisation in older adults. We aimed to examine the association between different multimorbidity patterns and unplanned hospitalisations over 5 years. To that end, 2,250 community-dwelling individuals aged 60 years and older from the Swedish National Study on Aging and Care in Kungsholmen (SNAC-K) were studied. Participants were grouped into six multimorbidity patterns using a fuzzy c-means cluster analysis. The associations between patterns and outcomes were tested using Cox models and negative binomial models. After 5 years, 937 (41.6%) participants experienced at least one unplanned hospitalisation. Compared to participants in the unspecific multimorbidity pattern, those in the cardiovascular diseases, anaemia and dementia pattern, the psychiatric disorders pattern and the metabolic and sleep disorders pattern presented with a higher hazard of first unplanned hospitalisation (hazard ratio range: 1.49–2.05; p < 0.05 for all), number of unplanned hospitalisations (incidence rate ratio (IRR) range: 1.89–2.44; p < 0.05 for all), in-hospital days (IRR range: 1.91–3.61; p < 0.05 for all), and 30-day unplanned readmissions (IRR range: 2.94–3.65; p < 0.05 for all). Different multimorbidity patterns displayed a differential association with unplanned hospital care utilisation. These findings call for a careful primary care follow-up of older adults with complex multimorbidity patterns.

Associations between physical multimorbidity patterns and common mental health disorders in middle-aged adults: A prospective analysis using data from the UK Biobank

“…In the current study, we identified five patterns of physical multimorbidity which are generally similar to those reported in previous studies. The most commonly identified disease pattern in previous studies has comprised cardiovascular and metabolic disorders [ 19 , [45] , [46] , [47] , [48] , [49] , [50] ], which is unsurprising considering the shared aetiology of these conditions. In the current study, we identified two cardiovascular patterns which might imply that there are different types of cardiovascular multimorbidity that are influenced by different factors.…”

“…The pain/gastrointestinal cluster we observed included conditions such as back pain, arthritis, and IBS. Several earlier studies also identified disease clusters which comprised musculoskeletal pain, arthritis, and gastrointestinal conditions [ 19 , 45 , 50 ]. Potential common mechanisms underlying this group of conditions includes the use of pain medications [54] , difficulty engaging in physical activity [55] , and potential changes in gut bacteria [56] .…”

Comorbidity status of deceased COVID-19 in-patients in Italy

“…Distinct patterns of multimorbidity have repeatedly been found to be differentially associated with negative health outcomes in the older population [14,15]. For example, when compared with other disease combinations, multimorbidity clusters including cardiovascular and neuropsychiatric diseases have displayed strong associations with functional impairment, hospitalization, and death [16][17][18].…”

Comprehensive Care through Family Medicine: Improving the Sustainability of Aging Societies

“…The results showed that family medicine could be a solution to the lack of specialists in rural areas, especially in aged societies. Among older patients, the problems of multimorbidity with polypharmacy are prevalent, and comprehensive care is critical for their safety, QOL, and end of life care [ 32 , 33 , 34 ]. Future studies can investigate the effectiveness of family medicine regarding patient’s QOL in multiple settings by adding ICD-11 categories which is revised one of ICD-10.…”