Association between multimorbidity and hospitalization in older adults: systematic review and meta-analysis

Abstract

Background Multimorbidity is defined as the presence of multiple chronic conditions in the same individual. Multimorbidity is more prevalent in older adults and can lead to several adverse health outcomes. Methods We systematically reviewed evidence from observational studies to verify the association between multimorbidity and hospitalization in older adults. Furthermore, we also aimed to identify whether it changes according to gender, advanced age, institutionalization, and wealth of the country of residence. We searched the PubMed, Embase and Scopus databases from December 2020 to April 2021. The analysed outcomes were as follows: hospitalization, length of stay and hospital readmission. Results Of the 6,948 studies identified in the databases, 33 were included in this review. From the meta-analysis results, it was found that multimorbidity, regardless of the country’s wealth, was linked to hospitalization in older adults (OR = 2.52, CI 95% = 1.87–3.38). Both definitions of multimorbidity, ≥2 (OR = 2.35, 95% CI = 1.34–4.12) and ≥3 morbidities (OR = 2.52, 95% CI = 1.87–3.38), were associated with hospitalization. Regardless of gender, multimorbidity was associated with hospitalization (OR = 1.98, 95% CI = 1.67–2.34) and with readmission (OR = 1.07, 95% CI = 1.04–1.09). However, it was not possible to verify the association between multimorbidity and length of stay. Conclusions Multimorbidity was linked to a higher hospitalization risk, and this risk was not affected by the country’s wealth and patient’s gender. Multimorbidity was also linked to a higher hospital readmission rate in older adults. PROSPERO Registration (Registration number: CRD42021229328).

Time-to-event analysis of factors influencing delay in discharge from a subacute Complex Discharge Unit during the first year of the pandemic (2020) in an Irish tertiary centre hospital

“…We acknowledge that the occurrence of MM is associated with higher rates of admission to the hospital and subsequent readmission. [15] Through the utilisation of the Charlson comorbidity index scoring, we sub-categorised complex MM as follows: ≤4 as mild to moderately complex and those with 5 or more as highly complex MM. [16] In our analysis, we were able to ascertain the association of MM with LOS.…”

Combinations of multiple long-term conditions and risk of hospitalisation and death during the winter season: population-based study of 48 million people in England

“…These results align with earlier studies that have consistently reported a significant burden of MLTC in diverse populations, with 37.2% as global prevalence and 39.2% across Europe (24–26). A recent systematic review found that in high, middle, and low-income countries there was a positive association between MLTC and hospitalization with a 2.5 times higher risk than those without MLTC (27). Our study is also the first to estimate the risks of winter hospitalisation and deaths associated with distinct combinations of MLTC.…”

Evaluation of the Impact Stratification Score in a Sample of Older Adult Patients with Multiple Chronic Conditions

“…Given the applicability of the seven domains assessed by the PROMIS-29 across a wide range of patient samples including older adults with multiple chronic conditions (MCC) [5], the ISS could be useful among patient samples other than those with chronic back pain. The disease burden of older adults with MCC is substantial [6], often resulting in functional impairment [7], and it can be challenging to characterize improvements in this hard-to-treat patient population [8]. In this study, we examine the dimensionality and psychometric properties of the ISS among older adult ambulatory patients with two or more chronic conditions, examine the association of ISS scores with demographic, clinical, and healthcare utilization variables, and evaluate the ISS relative to other PROMIS-29 scale scores in identifying specific conditions for these patients.…”