Multimorbidity in middle age predicts more subsequent hospital admissions than in older age: A nine-year retrospective cohort study of 121,188 discharged in-patients

Lai, Francisco Tsz Tsun; Yip, Benjamin H K; Guthrie, Bruce; Mercer, Stewart W; Chung, Raymond C.K.; Chung, Gary; Chau, Patsy Yuen-Kwan; Wong, Eliza Lai-Yi; Woo, Jean; Yeoh, Eng Kiong

doi:10.1016/j.ejim.2018.12.001

Cited by 31 publications

(37 citation statements)

References 51 publications

(77 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…3 44 Age was strongly associated with future hospitalisation and incident multimorbidity in our study and has been reported to increase hospitalised multimorbidity in elderly patients. 45 Many studies have found that women have a higher rate of multimorbidity than men, 6 44 46-48 but we observed the converse, with male sex strongly predicting future multimorbidity. The use of CCI in the context of prospective hospital admissions rather than cross-sectional multimorbidity in a primary care setting may explain the higher proportion of multimorbid men.…”

Section: Strengths and Limitations Of The Studycontrasting

confidence: 50%

Sociodemographic and lifestyle predictors of incident hospital admissions with multimorbidity in a general population, 1999–2019: the EPIC-Norfolk cohort

et al. 2020

View full text Add to dashboard Cite

BackgroundThe ageing population and prevalence of long-term disorders with multimorbidity are a major health challenge worldwide. The associations between comorbid conditions and mortality risk are well established; however, few prospective community-based studies have reported on prior risk factors for incident hospital admissions with multimorbidity. We aimed to explore the independent associations for a range of demographic, lifestyle and physiological determinants and the likelihood of subsequent hospital incident multimorbidity.MethodsWe examined incident hospital admissions with multimorbidity in 25 014 men and women aged 40–79 in a British prospective population-based study recruited in 1993–1997 and followed up until 2019. The determinants of incident multimorbidity, defined as Charlson Comorbidity Index ≥3, were investigated using multivariable logistic regression models for the 10-year period 1999–2009 and repeated with independent measurements in a second 10-year period 2009–2019.ResultsBetween 1999 and 2009, 18 179 participants (73% of the population) had a hospital admission. Baseline 5-year and 10-year incident multimorbidities were observed in 6% and 12% of participants, respectively. Age per 10-year increase (OR 2.19, 95% CI 2.06 to 2.33) and male sex (OR 1.32, 95% CI 1.19 to 1.47) predicted incident multimorbidity over 10 years. In the subset free of the most serious diseases at baseline, current smoking (OR 1.86, 95% CI 1.60 to 2.15), body mass index >30 kg/m² (OR 1.48, 95% CI 1.30 to 1.70) and physical inactivity (OR 1.16, 95% CI 1.04 to 1.29) were positively associated and plasma vitamin C (a biomarker of plant food intake) per SD increase (OR 0.86, 95% CI 0.81 to 0.91) inversely associated with incident 10-year multimorbidity after multivariable adjustment for age, sex, social class, education, alcohol consumption, systolic blood pressure and cholesterol. Results were similar when re-examined for a further time period in 2009–2019.ConclusionAge, male sex and potentially modifiable lifestyle behaviours including smoking, body mass index, physical inactivity and low fruit and vegetable intake were associated with increased risk of future incident hospital admissions with multimorbidity.

show abstract

Section: Strengths and Limitations Of The Studycontrasting

confidence: 50%

Sociodemographic and lifestyle predictors of incident hospital admissions with multimorbidity in a general population, 1999–2019: the EPIC-Norfolk cohort

et al. 2020

View full text Add to dashboard Cite

show abstract

“… 27 Most of the studies (n = 46, 60.5%) had a primary purpose of reporting the prevalence and patterns of multimorbidity. Of the total 76 studies, 52 (68.4%) were conducted in only six middle-income countries: Brazil, 27 – 42 China, 43 – 54 South Africa, 25 , 26 , 55 – 64 India, 65 – 72 Mexico 73 , 74 and Iran. 75 , 76 Studies based on multicountry data (n = 11) were based on data obtained from the World Health Organization’s (WHO’s) Study on Global Ageing and Adult Health (SAGE) and World Health Surveys.…”

Section: Resultsmentioning

confidence: 99%

Multimorbidity of chronic non-communicable diseases in low- and middle-income countries: A scoping review

et al. 2020

View full text Add to dashboard Cite

Background: Multimorbidity is rising in low- and middle-income countries (LMICs). However, the evidence on its epidemiology from LMICs settings is limited and the available literature has not been synthesized as yet. Objectives: To review the available evidence on the epidemiology of multimorbidity in LMICs. Methods: PubMed, Scopus, PsycINFO and Grey literature databases were searched. We followed the PRISMA-ScR reporting guideline. Results: Of 33, 110 articles retrieved, 76 studies were eligible for the epidemiology of multimorbidity. Of these 76 studies, 66 (86.8%) were individual country studies. Fifty-two (78.8%) of which were confined to only six middle-income countries: Brazil, China, South Africa, India, Mexico and Iran. The majority (n = 68, 89.5%) of the studies were crosssectional in nature. The sample size varied from 103 to 242, 952. The largest proportion (n = 33, 43.4%) of the studies enrolled adults. Marked variations existed in defining and measuring multimorbidity. The prevalence of multimorbidity in LMICs ranged from 3.2% to 90.5%. Conclusion and Recommendations: Studies on the epidemiology of multimorbidity in LMICs are limited and the available ones are concentrated in few countries. Despite variations in measurement and definition, studies consistently reported high prevalence of multimorbidity. Further research is urgently required to better understand the epidemiology of multimorbidity and define the best possible interventions to improve outcomes of patients with multimorbidity in LMICs.

show abstract

“…[8][9][10] A retrospective cohort study in Hong Kong, which used hospital data to measure multimorbidity, found that middleaged patients with multimorbidity had a greater number of hospital admissions than older patients. 11 There is recognition of the need for greater understanding of the determinants and outcomes of multimorbidity in middle-aged adults. 11 12 Research in a variety of populations, using a range of multimorbidity definitions and measures, has found multimorbidity to be associated with increased mortality.…”

Section: Introductionmentioning

confidence: 99%

Prevalence of secondary care multimorbidity in mid-life and its association with premature mortality in a large longitudinal cohort study

et al. 2020

View full text Add to dashboard Cite

ObjectivesMultimorbidity is the coexistence of two or more health conditions in an individual. Multimorbidity in younger adults is increasingly recognised as an important challenge. We assessed the prevalence of secondary care multimorbidity in mid-life and its association with premature mortality over 15 years of follow-up, in the Aberdeen Children of the 1950s (ACONF) cohort.MethodA prospective cohort study using linked electronic health and mortality records. Scottish ACONF participants were linked to their Scottish Morbidity Record hospital episode data and mortality records. Multimorbidity was defined as two or more conditions and was assessed using healthcare records in 2001 when the participants were aged between 45 and 51 years. The association between multimorbidity and mortality over 15 years of follow-up (to ages 60–66 years) was assessed using Cox proportional hazards regression. There was also adjustment for key covariates: age, gender, social class at birth, intelligence at age 7, secondary school type, educational attainment, alcohol, smoking, body mass index and adult social class.ResultsOf 9625 participants (51% males), 3% had multimorbidity. The death rate per 1000 person-years was 28.4 (95% CI 23.2 to 34.8) in those with multimorbidity and 5.7 (95% CI 5.3 to 6.1) in those without. In relation to the reference group of those with no multimorbidity, those with multimorbidity had a mortality HR of 4.5 (95% CI 3.4 to 6.0) over 15 years and this association remained when fully adjusted for the covariates (HR 2.5 (95% CI 1.5 to 4.0)).ConclusionMultimorbidity prevalence was 3% in mid-life when measured using secondary care administrative data. Multimorbidity in mid-life was associated with premature mortality.

show abstract

Multimorbidity in middle age predicts more subsequent hospital admissions than in older age: A nine-year retrospective cohort study of 121,188 discharged in-patients

Abstract: , E. K. (2019). Multimorbidity in middle age predicts more subsequent hospital admissions than in older age: A nine-year retrospective cohort study of 121,188 discharged in-patients.

Cited by 31 publications

References 51 publications

Sociodemographic and lifestyle predictors of incident hospital admissions with multimorbidity in a general population, 1999–2019: the EPIC-Norfolk cohort

Sociodemographic and lifestyle predictors of incident hospital admissions with multimorbidity in a general population, 1999–2019: the EPIC-Norfolk cohort

Multimorbidity of chronic non-communicable diseases in low- and middle-income countries: A scoping review

Prevalence of secondary care multimorbidity in mid-life and its association with premature mortality in a large longitudinal cohort study

Contact Info

Product

Resources

About