Multimorbidity and disease severity by age groups, in inpatients: cross-sectional study
Autor(a) principal: | |
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Data de Publicação: | 2019 |
Outros Autores: | , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | http://hdl.handle.net/10362/112979 |
Resumo: | ABSTRACT - Introduction: Multimorbidity (MM) by age groups curves behaviour and its relationship with disease severity are not well established. Considering the Charlson Index as a prognosis instrument to measure disease severity, the objectives were to characterise the MM and its severity through the Charlson index in Portuguese inpatients. Methods: A cross-sectional, descriptive study with an analytical component was drawn through data exported from the hospitalisations Homogeneous Diagnostic Groups database of the Portuguese-NHS during the year 2015. The study included 22 chronic health conditions: the 15 predicted in the Charlson index and 7 more (hypertension, obesity, dyslipidaemia, osteoarthritis, osteoporosis, anxiety and depression). The bi and multivariable analyses were performed through the generalised linear model considering binary logistic regression. In the analysis, the IBM SPSS version 24.0 tool was used. Results: A total of 800,376 hospitalisations were analysed, from which 42% (336,398) corresponds to males and 58% (463,978) to females. The average age of the sample was 59.8 years, being higher in men (62.34 years) than in women (57.95 years). The mean number of diagnostics per person was 1.6, being greater in men (1.8). Disease severity was also higher in males. The greatest disease severity (Charlson > 5) occurred at middle-aged (between 55 and 74 years). Throughout life behaviour of the average number of conditions and the average Charlson index without adjustment for age is similar. By the weight attributed to age, the Charlson index age-adjusted shows a sharper tendency of elevation after the forty years. The distribution by age groups of the age-adjusted Charlson index, categorised according to the cut-offs defined in the methodology (cut-off 0 to < 5; cut-off 5 to < 9; cut-off ≥9), showed an abrupt growth for the cut-off ≥9 at 55/59 years, peaking at 75/79 years, while for cut-off 5 at < 9 the most marked growth occurs at 65/69 and the peak about 5 years later than for the cut-off ≥9. After the 90 years old all measures averages (MM and severity disease) suffer a decline. Discussion: The results suggest that the greatest disease severity are male associated and occurred at middle ages. There was an association between any MM measure and the Charlson index. The MM curves behaviour showed a decline in nonagenary age, suggesting healthy people live longer. Questioned if the MM and its severity is not a middle age health issue. As limitations, we identified its cross-sectional design and the omission of socioeconomic information and the use of the same medical conditions to measure MM and disease severity. Other studies and analysis models should explore the complexity of the MM phenomenon and its impact on long life. |
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Multimorbidity and disease severity by age groups, in inpatients: cross-sectional studyMultimorbilidade e gravidade da doença por grupos etários, em pacientes internados: estudo transversalMultimorbidityComorbidityDisease burdenDisease severityMultimorbilidadeComorbilidadeCarga de doençaGravidade da doençaABSTRACT - Introduction: Multimorbidity (MM) by age groups curves behaviour and its relationship with disease severity are not well established. Considering the Charlson Index as a prognosis instrument to measure disease severity, the objectives were to characterise the MM and its severity through the Charlson index in Portuguese inpatients. Methods: A cross-sectional, descriptive study with an analytical component was drawn through data exported from the hospitalisations Homogeneous Diagnostic Groups database of the Portuguese-NHS during the year 2015. The study included 22 chronic health conditions: the 15 predicted in the Charlson index and 7 more (hypertension, obesity, dyslipidaemia, osteoarthritis, osteoporosis, anxiety and depression). The bi and multivariable analyses were performed through the generalised linear model considering binary logistic regression. In the analysis, the IBM SPSS version 24.0 tool was used. Results: A total of 800,376 hospitalisations were analysed, from which 42% (336,398) corresponds to males and 58% (463,978) to females. The average age of the sample was 59.8 years, being higher in men (62.34 years) than in women (57.95 years). The mean number of diagnostics per person was 1.6, being greater in men (1.8). Disease severity was also higher in males. The greatest disease severity (Charlson > 5) occurred at middle-aged (between 55 and 74 years). Throughout life behaviour of the average number of conditions and the average Charlson index without adjustment for age is similar. By the weight attributed to age, the Charlson index age-adjusted shows a sharper tendency of elevation after the forty years. The distribution by age groups of the age-adjusted Charlson index, categorised according to the cut-offs defined in the methodology (cut-off 0 to < 5; cut-off 5 to < 9; cut-off ≥9), showed an abrupt growth for the cut-off ≥9 at 55/59 years, peaking at 75/79 years, while for cut-off 5 at < 9 the most marked growth occurs at 65/69 and the peak about 5 years later than for the cut-off ≥9. After the 90 years old all measures averages (MM and severity disease) suffer a decline. Discussion: The results suggest that the greatest disease severity are male associated and occurred at middle ages. There was an association between any MM measure and the Charlson index. The MM curves behaviour showed a decline in nonagenary age, suggesting healthy people live longer. Questioned if the MM and its severity is not a middle age health issue. As limitations, we identified its cross-sectional design and the omission of socioeconomic information and the use of the same medical conditions to measure MM and disease severity. Other studies and analysis models should explore the complexity of the MM phenomenon and its impact on long life.RESUMO - Introdução: A relação entre magnitude e gravidade da multimorbilidade, por grupos etários, não está bem estabelecida. Considerando o índice de Charlson como um instrumento de prognóstico para medir a gravidade da multimorbilidade, os objetivos foram caracterizar a magnitude e gravidade da multimorbilidade em pacientes internados em Portugal. Métodos: Estudo transversal, descritivo, com um componente analítico, elaborado a partir de dados exportados da base de dados de Grupos de Diagnósticos Homogéneos de internamentos hospitalares do SNS durante o ano de 2015. O estudo incluiu 22 condições crónicas de saúde: as 15 previstas no índice de Charlson e mais sete (hipertensão, obesidade, dislipidemia, osteoartrose, osteoporose, ansiedade e depressão). A análise bi e multivariada foi realizada através do modelo linear generalizado, considerando a regressão logística binária. Na análise, foi usada a ferramenta IBM SPSS versão 24.0. Resultados: Foram analisadas 800’376 internamentos, das quais 42% (336’398) correspondem a homens. A idade média da amostra foi de 59,8 anos, sendo superior nos homens (62,34 anos) em relação às mulheres (57,95 anos). O número médio de diagnósticos por pessoa foi de 1,6, sendo maior nos homens (1,8). A gravidade da doença também foi maior no sexo masculino. A maior gravidade da doença (Charlson > 5) ocorreu na meia- idade (entre 55 e 74 anos). Por grupos etários, o comportamento do número médio de condições e do índice médio de Charlson sem ajuste para a idade é semelhante. Pelo peso atribuído à idade, o índice de Charlson ajustado à idade mostra uma tendência mais acentuada de elevação após os quarenta anos. A distribuição por faixa etária do índice de Charlson ajustado à idade, categorizada de acordo com os pontos de corte definidos na metodologia (ponto de corte 0 a < 5; ponto de corte 5 a < 9; ponto de corte ≥9), mostrou crescimento abrupto para o ponto de corte ≥9 aos 55/59 anos, com um pico aos 75/79 anos, enquanto para o ponto de corte 5 aos < 9 o crescimento mais acentuado ocorre aos 65/69 e o pico cerca de 5 anos mais tarde do que para o ponto de corte ≥9. Após os 90 anos, todas as médias das medidas de multimorbilidade (magnitude e gravidade) sofrem um declínio. Discussão: Os resultados sugerem que a maior gravidade da doença está associada ao sexo masculino e ocorreu na meiaidade. Houve associação entre qualquer medida de multimorbilidade e o índice de Charlson. O comportamento das curvas de multimorbilidade mostrou um declínio nos nonagenários, sugerindo que as pessoas saudáveis vivem mais tempo. Questionando-se se a gravidade da multimorbilidade não é um problema de meia-idade. Como limitações, identificou-se o delineamento transversal e a omissão de informações socioeconómicas, o uso das mesmas condições médicas para medir a magnitude e a gravidade da multimorbilidade. Outros estudos e modelos de análise devem explorar a complexidade do fenomeno da multimorbilidade e seu impacto ao longo da vida.Universidade Nova de Lisboa, Escola Nacional de Saúde PúblicaRUNBroeiro-Gonçalves, PaulaNogueira, PauloAGUIAR, PEDRO2021-03-03T12:40:22Z2019-012019-01-01T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttp://hdl.handle.net/10362/112979engBroeiro-Gonçalves, Paula; Nogueira, Paulo; Aguiar, Pedro - Multimorbidity and disease severity by age groups, in inpatients: cross-sectional study = Multimorbilidade e gravidade da doença por grupos etários, em pacientes internados: estudo transversal. Portuguese Journal of Public Health. ISSN 2504-3137. Vol. 37, Nº 1 (Janeiro/Abril 2019), p. 1-92504-313710.1159/000500119info:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2024-03-11T04:56:16Zoai:run.unl.pt:10362/112979Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-20T03:42:14.937998Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
Multimorbidity and disease severity by age groups, in inpatients: cross-sectional study Multimorbilidade e gravidade da doença por grupos etários, em pacientes internados: estudo transversal |
title |
Multimorbidity and disease severity by age groups, in inpatients: cross-sectional study |
spellingShingle |
Multimorbidity and disease severity by age groups, in inpatients: cross-sectional study Broeiro-Gonçalves, Paula Multimorbidity Comorbidity Disease burden Disease severity Multimorbilidade Comorbilidade Carga de doença Gravidade da doença |
title_short |
Multimorbidity and disease severity by age groups, in inpatients: cross-sectional study |
title_full |
Multimorbidity and disease severity by age groups, in inpatients: cross-sectional study |
title_fullStr |
Multimorbidity and disease severity by age groups, in inpatients: cross-sectional study |
title_full_unstemmed |
Multimorbidity and disease severity by age groups, in inpatients: cross-sectional study |
title_sort |
Multimorbidity and disease severity by age groups, in inpatients: cross-sectional study |
author |
Broeiro-Gonçalves, Paula |
author_facet |
Broeiro-Gonçalves, Paula Nogueira, Paulo AGUIAR, PEDRO |
author_role |
author |
author2 |
Nogueira, Paulo AGUIAR, PEDRO |
author2_role |
author author |
dc.contributor.none.fl_str_mv |
RUN |
dc.contributor.author.fl_str_mv |
Broeiro-Gonçalves, Paula Nogueira, Paulo AGUIAR, PEDRO |
dc.subject.por.fl_str_mv |
Multimorbidity Comorbidity Disease burden Disease severity Multimorbilidade Comorbilidade Carga de doença Gravidade da doença |
topic |
Multimorbidity Comorbidity Disease burden Disease severity Multimorbilidade Comorbilidade Carga de doença Gravidade da doença |
description |
ABSTRACT - Introduction: Multimorbidity (MM) by age groups curves behaviour and its relationship with disease severity are not well established. Considering the Charlson Index as a prognosis instrument to measure disease severity, the objectives were to characterise the MM and its severity through the Charlson index in Portuguese inpatients. Methods: A cross-sectional, descriptive study with an analytical component was drawn through data exported from the hospitalisations Homogeneous Diagnostic Groups database of the Portuguese-NHS during the year 2015. The study included 22 chronic health conditions: the 15 predicted in the Charlson index and 7 more (hypertension, obesity, dyslipidaemia, osteoarthritis, osteoporosis, anxiety and depression). The bi and multivariable analyses were performed through the generalised linear model considering binary logistic regression. In the analysis, the IBM SPSS version 24.0 tool was used. Results: A total of 800,376 hospitalisations were analysed, from which 42% (336,398) corresponds to males and 58% (463,978) to females. The average age of the sample was 59.8 years, being higher in men (62.34 years) than in women (57.95 years). The mean number of diagnostics per person was 1.6, being greater in men (1.8). Disease severity was also higher in males. The greatest disease severity (Charlson > 5) occurred at middle-aged (between 55 and 74 years). Throughout life behaviour of the average number of conditions and the average Charlson index without adjustment for age is similar. By the weight attributed to age, the Charlson index age-adjusted shows a sharper tendency of elevation after the forty years. The distribution by age groups of the age-adjusted Charlson index, categorised according to the cut-offs defined in the methodology (cut-off 0 to < 5; cut-off 5 to < 9; cut-off ≥9), showed an abrupt growth for the cut-off ≥9 at 55/59 years, peaking at 75/79 years, while for cut-off 5 at < 9 the most marked growth occurs at 65/69 and the peak about 5 years later than for the cut-off ≥9. After the 90 years old all measures averages (MM and severity disease) suffer a decline. Discussion: The results suggest that the greatest disease severity are male associated and occurred at middle ages. There was an association between any MM measure and the Charlson index. The MM curves behaviour showed a decline in nonagenary age, suggesting healthy people live longer. Questioned if the MM and its severity is not a middle age health issue. As limitations, we identified its cross-sectional design and the omission of socioeconomic information and the use of the same medical conditions to measure MM and disease severity. Other studies and analysis models should explore the complexity of the MM phenomenon and its impact on long life. |
publishDate |
2019 |
dc.date.none.fl_str_mv |
2019-01 2019-01-01T00:00:00Z 2021-03-03T12:40:22Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://hdl.handle.net/10362/112979 |
url |
http://hdl.handle.net/10362/112979 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
Broeiro-Gonçalves, Paula; Nogueira, Paulo; Aguiar, Pedro - Multimorbidity and disease severity by age groups, in inpatients: cross-sectional study = Multimorbilidade e gravidade da doença por grupos etários, em pacientes internados: estudo transversal. Portuguese Journal of Public Health. ISSN 2504-3137. Vol. 37, Nº 1 (Janeiro/Abril 2019), p. 1-9 2504-3137 10.1159/000500119 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.publisher.none.fl_str_mv |
Universidade Nova de Lisboa, Escola Nacional de Saúde Pública |
publisher.none.fl_str_mv |
Universidade Nova de Lisboa, Escola Nacional de Saúde Pública |
dc.source.none.fl_str_mv |
reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
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Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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RCAAP |
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RCAAP |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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