دورية أكاديمية
أعرض في EDS

Comorbidity and multimorbidity in patients with cirrhosis, hospitalised in an internal medicine ward: a monocentric, cross-sectional study.

التفاصيل البيبلوغرافية
العنوان: Comorbidity and multimorbidity in patients with cirrhosis, hospitalised in an internal medicine ward: a monocentric, cross-sectional study.
المؤلفون: Lenti MV; Department of Internal Medicine and Medical Therapeutics, University of Pavia, Pavia, Italy.; Department of Internal Medicine, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy., Ballesio A; Department of Internal Medicine and Medical Therapeutics, University of Pavia, Pavia, Italy.; Department of Internal Medicine, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy., Croce G; Department of Internal Medicine and Medical Therapeutics, University of Pavia, Pavia, Italy.; Department of Internal Medicine, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy., Brera AS; Department of Internal Medicine, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy., Padovini L; Department of Internal Medicine and Medical Therapeutics, University of Pavia, Pavia, Italy.; Department of Internal Medicine, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy., Bertolino G; Department of Internal Medicine, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy., Di Sabatino A; Department of Internal Medicine and Medical Therapeutics, University of Pavia, Pavia, Italy.; Department of Internal Medicine, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy., Klersy C; Service of Clinical Epidemiology & Biometry, Research Department, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy., Corazza GR; Department of Internal Medicine and Medical Therapeutics, University of Pavia, Pavia, Italy gr.corazza@smatteo.pv.it.; Department of Internal Medicine, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
المصدر: BMJ open [BMJ Open] 2024 May 01; Vol. 14 (5), pp. e077576. Date of Electronic Publication: 2024 May 01.
نوع المنشور: Journal Article; Research Support, Non-U.S. Gov't
اللغة: English
بيانات الدورية: Publisher: BMJ Publishing Group Ltd Country of Publication: England NLM ID: 101552874 Publication Model: Electronic Cited Medium: Internet ISSN: 2044-6055 (Electronic) Linking ISSN: 20446055 NLM ISO Abbreviation: BMJ Open Subsets: MEDLINE
أسماء مطبوعة: Original Publication: [London] : BMJ Publishing Group Ltd, 2011-
مواضيع طبية MeSH: Liver Cirrhosis*/epidemiology , Multimorbidity* , Internal Medicine* , Comorbidity*, Humans ; Male ; Female ; Cross-Sectional Studies ; Aged ; Aged, 80 and over ; Italy/epidemiology ; Hospitalization/statistics & numerical data ; Prevalence ; Middle Aged ; Non-alcoholic Fatty Liver Disease/epidemiology
مستخلص: Objectives: There are no data regarding the prevalence of comorbidity (ie, additional conditions in reference to an index disease) and multimorbidity (ie, co-occurrence of multiple diseases in which no one holds priority) in patients with liver cirrhosis. We sought to determine the rate and differences between comorbidity and multimorbidity depending on the aetiology of cirrhosis.
Design: This is a subanalysis of the San MAtteo Complexity (SMAC) study. We have analysed demographic, clinical characteristics and rate of comorbidity/multimorbidity of patients with liver cirrhosis depending on the aetiology-alcoholic, infectious and non-alcoholic fatty liver disease (NAFLD). A multivariable analysis for factors associated with multimorbidity was fitted.
Setting: Single-centre, cross-sectional study conducted in a tertiary referral, academic, internal medicine ward in northern Italy (November 2017-November 2019).
Participants: Data from 1433 patients previously enrolled in the SMAC study were assessed; only those with liver cirrhosis were eventually included.
Results: Of the 1433 patients, 172 (median age 79 years, IQR 67-84; 83 females) had liver cirrhosis. Patients with cirrhosis displayed higher median Cumulative Illness Rating Scale (CIRS) comorbidity (4, IQR 3-5; p=0.01) and severity (1.85, IQR 16.-2.0; p<0.001) indexes and lower educational level (103, 59.9%; p=0.003). Patients with alcohol cirrhosis were significantly younger (median 65 years, IQR 56-79) than patients with cirrhosis of other aetiologies (p<0.001) and more commonly males (25, 75.8%). Comorbidity was more prevalent in patients with alcohol cirrhosis (13, 39.4%) and multimorbidity was more prevalent in viral (64, 81.0%) and NAFLD (52, 86.7%) cirrhosis (p=0.015). In a multivariable model for factors associated with multimorbidity, a CIRS comorbidity index >3 (OR 2.81, 95% CI 1.14 to 6.93, p=0.024) and admission related to cirrhosis (OR 0.19, 95% CI 0.07 to 0.54, p=0.002) were the only significant associations.
Conclusions: Comorbidity is more common in alcohol cirrhosis compared with other aetiologies in a hospital, internal medicine setting.
Competing Interests: Competing interests: None declared.
(© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
References: J Hepatol. 2016 Jun;64(6):1388-402. (PMID: 27062661)
World J Gastroenterol. 2014 Jun 21;20(23):7223-30. (PMID: 24966593)
J Clin Epidemiol. 2019 Jan;105:142-146. (PMID: 30253215)
J Hepatol. 2018 Jul;69(1):154-181. (PMID: 29628280)
Intern Emerg Med. 2022 Jun;17(4):1033-1041. (PMID: 34993840)
J Hepatol. 2006 Jan;44(1):217-31. (PMID: 16298014)
J Investig Med. 2014 Oct;62(7):920-6. (PMID: 25203153)
J Gen Intern Med. 2015 Dec;30(12):1741-7. (PMID: 26048275)
PLoS One. 2020 Jun 11;15(6):e0234112. (PMID: 32525896)
Rev Gastroenterol Mex (Engl Ed). 2021 Jan-Mar;86(1):28-35. (PMID: 32345507)
Addiction. 2009 Sep;104(9):1487-500. (PMID: 19686518)
BMJ. 2001 Sep 15;323(7313):625-8. (PMID: 11557716)
J Clin Epidemiol. 2019 Jan;105:vi-viii. (PMID: 30522770)
Scand J Gastroenterol. 2012 Jun;47(6):702-9. (PMID: 22428859)
J Am Geriatr Soc. 1999 Nov;47(11):1359-63. (PMID: 10573448)
Hepatology. 2022 Apr;75(4):1026-1037. (PMID: 34496071)
Ann Intern Med. 2011 Dec 20;155(12):797-804. (PMID: 22184686)
Md State Med J. 1965 Feb;14:61-5. (PMID: 14258950)
BMC Public Health. 2020 Nov 30;20(1):1820. (PMID: 33256682)
Eur J Intern Med. 2019 Mar;61:9-14. (PMID: 30528261)
Mayo Clin Proc. 2021 Apr;96(4):1006-1016. (PMID: 33714602)
Science. 1999 Apr 2;284(5411):87-9. (PMID: 10102823)
Age Ageing. 2021 Feb 26;50(2):498-504. (PMID: 32926127)
Lancet. 2014 May 17;383(9930):1749-61. (PMID: 24480518)
Int J Environ Res Public Health. 2020 Apr 20;17(8):. (PMID: 32325957)
BMC Gastroenterol. 2020 Apr 3;20(1):84. (PMID: 32245414)
J Gen Intern Med. 2007 Dec;22 Suppl 3:382-90. (PMID: 18026806)
Lancet. 2021 Oct 9;398(10308):1359-1376. (PMID: 34543610)
Ann Intern Med. 2011 Dec 20;155(12):851-2. (PMID: 22184693)
J Gen Intern Med. 2019 Nov;34(11):2316-2318. (PMID: 31388918)
Intern Emerg Med. 2017 Dec;12(8):1313-1318. (PMID: 28710713)
Science. 2015 Feb 20;347(6224):1257601. (PMID: 25700523)
BMC Gastroenterol. 2009 May 18;9:35. (PMID: 19450284)
Age Ageing. 2006 Sep;35(5):526-9. (PMID: 16757522)
فهرسة مساهمة: Keywords: Adult gastroenterology; Aging; Hepatobiliary disease
تواريخ الأحداث: Date Created: 20240501 Date Completed: 20240501 Latest Revision: 20240512
رمز التحديث: 20240512
مُعرف محوري في PubMed: PMC11086508
DOI: 10.1136/bmjopen-2023-077576
PMID: 38692714
قاعدة البيانات: MEDLINE
الوصف
تدمد:2044-6055
DOI:10.1136/bmjopen-2023-077576