Multiple Chronic Conditions and Psychosocial Limitations in Patients Hospitalized with an Acute Coronary Syndrome

Abstract

Background As adults live longer, multiple chronic conditions have become more prevalent over the past several decades. We describe the prevalence of, and patient characteristics associated with, cardiac and non-cardiac-related multimorbidities in patients discharged from the hospital after an acute coronary syndrome. Methods We studied 2,174 patients discharged from the hospital after an acute coronary syndrome at 6 medical centers in Massachusetts and Georgia between April, 2011 and May, 2013. Hospital medical records yielded clinical information including presence of 8 cardiac-related and 8 non-cardiac-related morbidities on admission. We assessed multiple psychosocial characteristics during the index hospitalization using standardized in-person instruments. Results The mean age of the study sample was 61 years, 67% were men, and 81% were non-Hispanic whites. The most common cardiac-related morbidities were hypertension, hyperlipidemia, and diabetes (76%, 69%, and 31%, respectively). Arthritis, chronic pulmonary disease, and depression (20%, 18%, and 13%, respectively) were the most common non-cardiac morbidities. Patients with ≥4 morbidities (37% of the population) were slightly older and more frequently female than those with 0–1 morbidity; they were also heavier and more likely to be cognitively impaired (26% vs. 12%), have symptoms of moderate/severe depression (31% vs. 15%), high perceived stress (48% vs. 32%), a limited social network (22% vs. 15%), low health literacy (42% vs. 31%), and low health numeracy (54% vs. 42%). Conclusions Multimorbidity, highly prevalent in patients hospitalized with an acute coronary syndrome, is strongly associated with indices of psychosocial deprivation. This emphasizes the challenge of caring for these patients, which extends well beyond acute coronary syndrome management.

The relationship between multimorbidity and cardiovascular risk in patients with acute coronary syndrome

“…Мультиморбидный профиль, характерный для боль-ных с ОКС, полученный в настоящем исследовании, не отличался от такового в доступной литературе [13,17,18]. Так, у больных с ОКС в приведенном исследовании ча-стота выявления АГ составила 85,3%, дисфункции по-чек -34,5%, ожирения -34%, МФА -22,1%, ане-мии -20,2%, СД -18,6%, инсульта -10,5%.…”

“…Согласно собственным данным и данным литерату-ры, мультиморбидность ассоциируется не только с пожи-лым возрастом [20], но и с женским полом [17,18]. Тем не менее имеются данные об отсутствии связи мультимор-бидности с полом [21].…”

Demografinių Veiksnių Įtaka Pacientų, Sergančių Ūminiu Koronariniu Sindromu, Su Sveikata Susijusiai Gyvenimo Kokybei

“…Dviejų metų atliktame tyrime M. Tisminetzky ir kt. [13] Jungtinėse Amerikos Valstijose nustatė, jog moterų taip pat buvo žymiai daugiau sergančių lėtinėmis ligomis, kurios ribojo jų fizinę veiklą ir jos turėjo daugiau emocinių problemų.…”

The longitudinal association of multimorbidity on loneliness and network size: Findings from a population‐based study

“…20 Literature providing longitudinal insight on the relationship exists. 23 Undertaking longitudinal analyses with panel, data come with some advantages compared with cross-sectional analyses. Furthermore, in these studies, only baseline observations of disease counts were used to predict subsequent loneliness.…”

“…While longitudinal results are lacking, it has been reported that individuals with four or more chronic illnesses are more likely to have limited social networks compared with individuals with one or less chronic conditions. 23 Undertaking longitudinal analyses with panel, data come with some advantages compared with cross-sectional analyses. It is possible to control for time-invariant unobserved heterogeneity such as cultural factors or genetic disposition, which is a major challenge in observational studies.…”