Multimorbidity and mortality
Background: Knowledge about prevalent and deadly combinations of multimorbidity is needed. Objective: To determine the nationwide prevalence of multimorbidity and estimate mortality for the most prevalent combinations of one to five diagnosis groups. Furthermore, to assess the excess mortality of th...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
SAGE Publishing
2018-10-01
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| Series: | Journal of Comorbidity |
| Online Access: | https://doi.org/10.1177/2235042X18804063 |
| _version_ | 1818234656405848064 |
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| author | TG Willadsen V Siersma DR Nicolaisdóttir R Køster-Rasmussen DE Jarbøl S Reventlow SW Mercer N de Fine Olivarius |
| author_facet | TG Willadsen V Siersma DR Nicolaisdóttir R Køster-Rasmussen DE Jarbøl S Reventlow SW Mercer N de Fine Olivarius |
| author_sort | TG Willadsen |
| collection | DOAJ |
| description | Background: Knowledge about prevalent and deadly combinations of multimorbidity is needed. Objective: To determine the nationwide prevalence of multimorbidity and estimate mortality for the most prevalent combinations of one to five diagnosis groups. Furthermore, to assess the excess mortality of the combination of two groups compared to the product of mortality associated with the single groups. Design: A prospective cohort study using Danish registries and including 3.986.209 people aged ≥18 years on 1 January, 2000. Multimorbidity was defined as having diagnoses from at least 2 of 10 diagnosis groups: lung, musculoskeletal, endocrine, mental, cancer, neurological, gastrointestinal, cardiovascular, kidney, and sensory organs. Logistic regression (odds ratios, ORs) and ratio of ORs (ROR) were used to study mortality and excess mortality. Results: Prevalence of multimorbidity was 7.1% in the Danish population. The most prevalent combination was the musculoskeletal–cardiovascular (0.4%), which had double the mortality (OR, 2.03) compared to persons not belonging to any of the diagnosis groups but showed no excess mortality (ROR, 0.97). The neurological–cancer combination had the highest mortality (OR, 6.35), was less prevalent (0.07%), and had no excess mortality (ROR, 0.94). Cardiovascular–lung was moderately prevalent (0.2%), had high mortality (OR, 5.75), and had excess mortality (ROR, 1.18). Endocrine–kidney had high excess mortality (ROR, 1.81) and cancer–mental had low excess mortality (ROR, 0.66). Mortality increased with the number of groups. Conclusions: All combinations had increased mortality risk with some of them having up to a six-fold increased risk. Mortality increased with the number of diagnosis groups. Most combinations did not increase mortality above that expected, that is, were additive rather than synergistic. |
| first_indexed | 2024-12-12T11:41:32Z |
| format | Article |
| id | doaj.art-ad2ccefee9ac40d4b31fa6d9935358ba |
| institution | Directory Open Access Journal |
| issn | 2235-042X |
| language | English |
| last_indexed | 2024-12-12T11:41:32Z |
| publishDate | 2018-10-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Journal of Comorbidity |
| spelling | doaj.art-ad2ccefee9ac40d4b31fa6d9935358ba2022-12-22T00:25:31ZengSAGE PublishingJournal of Comorbidity2235-042X2018-10-01810.1177/2235042X18804063Multimorbidity and mortalityTG Willadsen0V Siersma1DR Nicolaisdóttir2R Køster-Rasmussen3DE Jarbøl4S Reventlow5SW Mercer6N de Fine Olivarius7 The Research Unit for General Practice and Section of General Practice, Institute of Public Health, University of Copenhagen, Copenhagen, Denmark The Research Unit for General Practice and Section of General Practice, Institute of Public Health, University of Copenhagen, Copenhagen, Denmark The Research Unit for General Practice and Section of General Practice, Institute of Public Health, University of Copenhagen, Copenhagen, Denmark The Research Unit for General Practice and Section of General Practice, Institute of Public Health, University of Copenhagen, Copenhagen, Denmark Department of Public Health, The Research Unit of General Practice, University of Southern Denmark, Odense, Denmark The Research Unit for General Practice and Section of General Practice, Institute of Public Health, University of Copenhagen, Copenhagen, Denmark General Practice and Primary Care, Institute of Health and Wellbeing, University of Glasgow, Glasgow, Scotland The Research Unit for General Practice and Section of General Practice, Institute of Public Health, University of Copenhagen, Copenhagen, DenmarkBackground: Knowledge about prevalent and deadly combinations of multimorbidity is needed. Objective: To determine the nationwide prevalence of multimorbidity and estimate mortality for the most prevalent combinations of one to five diagnosis groups. Furthermore, to assess the excess mortality of the combination of two groups compared to the product of mortality associated with the single groups. Design: A prospective cohort study using Danish registries and including 3.986.209 people aged ≥18 years on 1 January, 2000. Multimorbidity was defined as having diagnoses from at least 2 of 10 diagnosis groups: lung, musculoskeletal, endocrine, mental, cancer, neurological, gastrointestinal, cardiovascular, kidney, and sensory organs. Logistic regression (odds ratios, ORs) and ratio of ORs (ROR) were used to study mortality and excess mortality. Results: Prevalence of multimorbidity was 7.1% in the Danish population. The most prevalent combination was the musculoskeletal–cardiovascular (0.4%), which had double the mortality (OR, 2.03) compared to persons not belonging to any of the diagnosis groups but showed no excess mortality (ROR, 0.97). The neurological–cancer combination had the highest mortality (OR, 6.35), was less prevalent (0.07%), and had no excess mortality (ROR, 0.94). Cardiovascular–lung was moderately prevalent (0.2%), had high mortality (OR, 5.75), and had excess mortality (ROR, 1.18). Endocrine–kidney had high excess mortality (ROR, 1.81) and cancer–mental had low excess mortality (ROR, 0.66). Mortality increased with the number of groups. Conclusions: All combinations had increased mortality risk with some of them having up to a six-fold increased risk. Mortality increased with the number of diagnosis groups. Most combinations did not increase mortality above that expected, that is, were additive rather than synergistic.https://doi.org/10.1177/2235042X18804063 |
| spellingShingle | TG Willadsen V Siersma DR Nicolaisdóttir R Køster-Rasmussen DE Jarbøl S Reventlow SW Mercer N de Fine Olivarius Multimorbidity and mortality Journal of Comorbidity |
| title | Multimorbidity and mortality |
| title_full | Multimorbidity and mortality |
| title_fullStr | Multimorbidity and mortality |
| title_full_unstemmed | Multimorbidity and mortality |
| title_short | Multimorbidity and mortality |
| title_sort | multimorbidity and mortality |
| url | https://doi.org/10.1177/2235042X18804063 |
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