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dc.contributor.authorTisminetzky, Mayra
dc.contributor.authorGurwitz, Jerry H.
dc.contributor.authorFan, Dongjie
dc.contributor.authorReynolds, Kristi
dc.contributor.authorSmith, David H.
dc.contributor.authorMagid, David J.
dc.contributor.authorSung, Sue Hee
dc.contributor.authorMurphy, Terrence E.
dc.contributor.authorGoldberg, Robert J.
dc.contributor.authorGo, Alan S.
dc.date2022-08-11T08:10:35.000
dc.date.accessioned2022-08-23T17:13:35Z
dc.date.available2022-08-23T17:13:35Z
dc.date.issued2018-09-24
dc.date.submitted2018-11-08
dc.identifier.citation<p>J Am Geriatr Soc. 2018 Sep 24. doi: 10.1111/jgs.15590. [Epub ahead of print] <a href="https://doi.org/10.1111/jgs.15590">Link to article on publisher's site</a></p>
dc.identifier.issn0002-8614 (Linking)
dc.identifier.doi10.1111/jgs.15590
dc.identifier.pmid30246862
dc.identifier.urihttp://hdl.handle.net/20.500.14038/46761
dc.description.abstractOBJECTIVES: To assess multimorbidity burden and its association with clinical outcomes in adults with heart failure (HF) according to sex, age, and HF type. DESIGN: Retrospective cohort study. SETTING: Five healthcare delivery systems across the United States. PARTICIPANTS: Adults with HF (N=114,553). MEASUREMENTS: We characterized participants with respect to the presence of 26 chronic conditions categorized into quartiles based on overall burden of comorbidity ( < 5, 5-6, 7-8, > /=9). Outcomes included all-cause death and hospitalization for HF or any cause. Multivariable Cox regression was used to evaluate the adjusted association between categorized burden of multimorbidity burden and outcomes. RESULTS: Individuals with more morbidities were more likely to die than those with fewer then 5 morbidities (5-6 morbidities: adjusted hazard ratio (aHR)=1.27 (95% confidence interval (CI)=1.24-1.31; 7-8 morbidities: aHR=1.52, 95% CI=1.48-1.57; > /=9 morbidities: aHR=1.92, 95% CI=1.86-1.99). There was a graded, higher adjusted rate of any-cause hospitalization associated with 5 or 6 (aHR=1.28, 95% CI=1.25-1.30), 7 or 8 (aHR=1.47, 95% CI=1.44-1.50), or 9 or more (aHR=1.77, 95% CI=1.73-1.82) morbidities (vs < 5). Similar findings were observed for HF-specific hospitalization in those with 5 or 6 (aHR=1.22, 95% CI=1.19-1.26), 7 or 8 (aHR=1.39, 95% CI=1.34-1.44), or 9 or more (aHR 1.68, 95% CI=1.61-1.74) morbidities (vs < 5). Consistent findings were seen according to sex, age group, and HF type (preserved, reduced, borderline HF), in the association between categorical burden of multimorbidity and outcomes especially prominent in individuals younger than 65. CONCLUSION: After adjustment, higher levels of multimorbidity predicted worse HF outcomes and may be an important consideration in strategies to improve clinical and person-centered outcomes.
dc.language.isoen_US
dc.relation<p><a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&list_uids=30246862&dopt=Abstract">Link to Article in PubMed</a></p>
dc.relation.urlhttps://doi.org/10.1111/jgs.15590
dc.subjectcomorbidity
dc.subjectheart failure
dc.subjectmultimorbidity
dc.subjectmultiple chronic conditions
dc.subjectCardiovascular Diseases
dc.subjectEpidemiology
dc.subjectGeriatrics
dc.subjectHealth Services Administration
dc.subjectHealth Services Research
dc.titleMultimorbidity Burden and Adverse Outcomes in a Community-Based Cohort of Adults with Heart Failure
dc.typeArticle
dc.source.journaltitleJournal of the American Geriatrics Society
dc.identifier.legacycoverpagehttps://escholarship.umassmed.edu/qhs_pp/1221
dc.identifier.contextkey13269237
html.description.abstract<p>OBJECTIVES: To assess multimorbidity burden and its association with clinical outcomes in adults with heart failure (HF) according to sex, age, and HF type.</p> <p>DESIGN: Retrospective cohort study.</p> <p>SETTING: Five healthcare delivery systems across the United States.</p> <p>PARTICIPANTS: Adults with HF (N=114,553).</p> <p>MEASUREMENTS: We characterized participants with respect to the presence of 26 chronic conditions categorized into quartiles based on overall burden of comorbidity ( < 5, 5-6, 7-8, > /=9). Outcomes included all-cause death and hospitalization for HF or any cause. Multivariable Cox regression was used to evaluate the adjusted association between categorized burden of multimorbidity burden and outcomes.</p> <p>RESULTS: Individuals with more morbidities were more likely to die than those with fewer then 5 morbidities (5-6 morbidities: adjusted hazard ratio (aHR)=1.27 (95% confidence interval (CI)=1.24-1.31; 7-8 morbidities: aHR=1.52, 95% CI=1.48-1.57; > /=9 morbidities: aHR=1.92, 95% CI=1.86-1.99). There was a graded, higher adjusted rate of any-cause hospitalization associated with 5 or 6 (aHR=1.28, 95% CI=1.25-1.30), 7 or 8 (aHR=1.47, 95% CI=1.44-1.50), or 9 or more (aHR=1.77, 95% CI=1.73-1.82) morbidities (vs < 5). Similar findings were observed for HF-specific hospitalization in those with 5 or 6 (aHR=1.22, 95% CI=1.19-1.26), 7 or 8 (aHR=1.39, 95% CI=1.34-1.44), or 9 or more (aHR 1.68, 95% CI=1.61-1.74) morbidities (vs < 5). Consistent findings were seen according to sex, age group, and HF type (preserved, reduced, borderline HF), in the association between categorical burden of multimorbidity and outcomes especially prominent in individuals younger than 65.</p> <p>CONCLUSION: After adjustment, higher levels of multimorbidity predicted worse HF outcomes and may be an important consideration in strategies to improve clinical and person-centered outcomes.</p>
dc.identifier.submissionpathqhs_pp/1221
dc.contributor.departmentDepartment of Quantitative Health Sciences
dc.contributor.departmentDivision of Geriatric Medicine, Department of Medicine
dc.contributor.departmentMeyers Primary Care Institute


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