Patterns of multimorbidity in internal medicine patients in Swiss university hospitals: a multicentre cohort study.

Aubert, Carole E; Fankhauser, Niklaus; Vasques-Vidal, Pedro-Manuel; Stirnemann, Jérôme; Aujesky, Drahomir; Limacher, Andreas; Donzé, Jacques (2019). Patterns of multimorbidity in internal medicine patients in Swiss university hospitals: a multicentre cohort study. Swiss medical weekly, 149, w20094. EMH Schweizerischer Ärzteverlag 10.4414/smw.2019.20094

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AIMS OF THE STUDY Despite the high prevalence of multimorbidity, we lack detailed descriptive data on the most prevalent combinations of chronic comorbidities in Switzerland. We aimed to describe and quantify the most prevalent combinations of comorbidities in internal medicine multimorbid inpatients. METHODS We conducted a multicentre retrospective cohort study including all consecutive adults (n = 42,739) discharged from the general internal medicine department of three Swiss tertiary teaching hospitals in 2010–2011. We used the Chronic Condition Indicator and the Clinical Classification Software to classify International Classification of Diseases diagnosis codes into chronic or acute diseases, into body system categories and into categories of chronic comorbidities. We defined multimorbidity as ≥2 chronic diseases. We described the most prevalent combinations of comorbidities and their prevalence. RESULTS Seventy-nine percent (n = 33,871) of the patients were multimorbid, with a median of four chronic diseases. Chronic heart disease, chronic kidney disease, solid malignancy and substance-related disorders were the most prevalent comorbidities, with a prevalence of more than 10% for each. All these comorbidities were frequently found in combination with chronic obstructive pulmonary disease and bronchiectasis, pulmonary heart disease, and peripheral and visceral atherosclerosis. Chronic heart disease was identified in 80% of the most prevalent combinations. Half of the combinations occurred more often than it would have been expected if they were independent. CONCLUSIONS The vast majority of patients fulfilled the criteria for multimorbidity. Chronic heart disease, chronic kidney disease, solid malignancy and substance-related disorders were each present in at least one tenth of the patients. This in-depth description of the most frequent comorbidities and of their frequent associations in a multicentre population may advise healthcare providers to improve preventive care and develop appropriate guidelines for multimorbid patients. &nbsp.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Medical Education > Institute of General Practice and Primary Care (BIHAM)
04 Faculty of Medicine > Pre-clinic Human Medicine > CTU Bern
04 Faculty of Medicine > Department of General Internal Medicine (DAIM) > Clinic of General Internal Medicine

UniBE Contributor:

Aubert, Carole Elodie; Fankhauser, Niklaus; Aujesky, Drahomir; Limacher, Andreas and Donzé, Jacques

Subjects:

600 Technology > 610 Medicine & health
300 Social sciences, sociology & anthropology > 360 Social problems & social services

ISSN:

1424-7860

Publisher:

EMH Schweizerischer Ärzteverlag

Language:

English

Submitter:

Christine Baumgartner

Date Deposited:

18 Jul 2019 10:43

Last Modified:

05 Sep 2019 11:46

Publisher DOI:

10.4414/smw.2019.20094

PubMed ID:

31256414

BORIS DOI:

10.7892/boris.131680

URI:

https://boris.unibe.ch/id/eprint/131680

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