Physiological markers and multimorbidity

Ferreira, Gustavo Dias; Simões, José Augusto Rodrigues; Senaratna, Chamara V.; Timm, Pierre Fernando; Batista, Sandro Rodrigues; Nunes, Bruno Pereira

doi:10.1177/2235042x18806986

Cited by 27 publications

(24 citation statements)

References 37 publications

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“…IL-6 has been shown to be associated to severity in several diseases. 10 Altogether TA B L E 1 Results from clustering analysis our results suggest that the initial innate immune response in SCARs can predict further disease evolution.…”

Section: Correspondencementioning

confidence: 78%

Acute generalized exanthematous pustulosis and epidermal necrolysis differ in innate cytokine patterns

Lalevée¹,

Audureau

Riou³

et al. 2019

Clin Experimental Allergy

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Section: Correspondencementioning

confidence: 78%

Acute generalized exanthematous pustulosis and epidermal necrolysis differ in innate cytokine patterns

Lalevée¹,

Audureau

Riou³

et al. 2019

Clin Experimental Allergy

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“…Although the knowledge is still incipient on the biological mechanism that increases the risk of infections among persons with multimorbidity, the mechanism appears to be associated with increased inflammation and the body's decreased immune response capacity 26,27,28 . Nevertheless, it essential to understand this process in greater detail, considering the identification of differences according to morbidity patterns 29 .…”

Section: Discussionmentioning

confidence: 99%

Multimorbidade e população em risco para COVID-19 grave no Estudo Longitudinal da Saúde dos Idosos Brasileiros

et al. 2020

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O objetivo deste trabalho foi medir a ocorrência de multimorbidade e estimar o número de indivíduos na população brasileira com 50 anos ou mais em risco para COVID-19 grave. Estudo transversal de base nacional com dados do Estudo Longitudinal da Saúde dos Idosos Brasileiros (ELSI-Brasil), conduzido em 2015-2016, com 9.412 indivíduos com 50 anos ou mais. A multimorbidade foi caracterizada como ≥ 2 condições crônicas com base em uma lista de 15 morbidades consideradas de risco para COVID-19 grave. As análises incluíram cálculo de prevalência e estimativa do número absoluto de pessoas na população em risco. Autoavaliação do estado de saúde, fragilidade e atividades básicas da vida diária foram utilizadas como marcadores da situação de saúde. Sexo, idade, região geopolítica e escolaridade foram usados como covariáveis. Cerca de 80% dos indivíduos da amostra apresentaram pelo menos alguma das morbidades avaliadas, o que representa cerca de 34 milhões de indivíduos; a multimorbidade foi referida por 52% da população em estudo, com maior proporção nas regiões Centro-oeste, Sudeste e Sul. Doenças cardiovasculares e obesidade foram as condições crônicas mais frequentes. Estima-se que 2,4 milhões de brasileiros estejam em risco grave de saúde. Desigualdades segundo a escolaridade foram observadas. O número de pessoas com 50 anos ou mais que apresentam morbidades de risco para COVID-19 grave é elevado tanto em termos relativos quanto absolutos. A estimativa apresentada é importante para planejar as estratégias de monitoramento das pessoas com morbidades crônicas e de prevenção no enfrentamento do novo coronavírus.

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“…Это может быть обусловлено взаимодействиями в рамках коморбидности «болезнь -болезнь» [9]. Возможен также вклад системного воспаления, поскольку ранее была описана прямая связь выраженности коморбидности с уровнем провоспалительных цитокинов в крови [8], ведущих к развитию сердечно-сосудистых катастроф [3], а также с многососудистым поражением коронарных артерий, ассоциированного с коморбидностью [26]. Однако проведение ЧКВ у коморбидных пациентов ассоциируется со значимым улучшением отдаленного прогноза по сравнению с консервативной стратегией лечения.…”

Section: Discussionunclassified

Predictive importance of comorbidity in patients with myocardial infarction and different strategy of treatment

Зыков

Кашталап

Полтаранина

et al. 2019

Medicinskij alfavit

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The aim of the study was to compare the 1-year results of conservative and invasive tactics of treating myocardial infarction (MI) in patients with different severity of comorbid background.Material and methods. The presented results are based on registry in City Hospital No. 4 of Sochi. The present analysis included patients with a diagnosis of myocardial infarction (n = 1 176). Upon discharge from the hospital, all patients underwent analysis of the severity of comorbidity using the Charlson Comorbidity Index (CCI). A year later, 791 patients managed to find out the prognosis after discharge from the hospital. 1-year mortality was 12.6 % (n = 100).Results. The frequency of coronary angiography (CA) and percutaneous coronary intervention (PCI) in patients with CCI = 0 (no or minimal comorbidity, n = 408) was 84.3 % and 63.5 %, with a CCI of 1–2 (moderate comorbidity), n = 438) was 68.0 % and 44.8 %, with CCI ≥ 3 (expressed comorbidity, n = 330) was 50.3 % and 25.8 %, respectively. At the same time, conducting PCI at the hospital observation stage was associated with a decrease mortality during the year after discharge from the hospital from 18.5 % to 5.8 %, p < 0.0001. The greatest positive effect of PCI for optimizing the long-term prognosis of (1 year) was achieved in the group of patients with severe comorbidity (CCI ≥ 3), where the NNT (number needed to treat) was 7. The relative risk of 1-year mortality in patients with severe comorbidity compared to the minimum in the PCI group was 6.75, in the conservative treatment group was 4.63.Conclusion. The results of this study showed that PCI in MI is more often performed by younger, less comorbid patients with a lower risk on the GRACE scale. At the same time, the 1-year survival of patients with MI was significantly higher after PCI compared to the primary conservative treatment strategy, regardless of the severity of comorbidity, and the greatest improvement in the long-term prognosis of PCI was observed in patients with severe comorbidity, as determined by the CCI ≥ 3.

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Physiological markers and multimorbidity

Cited by 27 publications

References 37 publications

Acute generalized exanthematous pustulosis and epidermal necrolysis differ in innate cytokine patterns

Acute generalized exanthematous pustulosis and epidermal necrolysis differ in innate cytokine patterns

Multimorbidade e população em risco para COVID-19 grave no Estudo Longitudinal da Saúde dos Idosos Brasileiros

Predictive importance of comorbidity in patients with myocardial infarction and different strategy of treatment

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