Interaction effects of multimorbidity and frailty on adverse health outcomes in elderly hospitalised patients.
Journal
Scientific reports
ISSN: 2045-2322
Titre abrégé: Sci Rep
Pays: England
ID NLM: 101563288
Informations de publication
Date de publication:
19 08 2022
19 08 2022
Historique:
received:
15
04
2021
accepted:
09
08
2022
entrez:
19
8
2022
pubmed:
20
8
2022
medline:
24
8
2022
Statut:
epublish
Résumé
We quantified the interaction of multimorbidity and frailty and their impact on adverse health outcomes in the hospital setting. Using aretrospective cohort study of persons aged ≥ 75 years, admitted to hospital during 2010-2012 in New South Wales, Australia, and linked with mortality data, we constructed multimorbidity, frailty risk and outcomes: prolonged length of stay (LOS), 30-day mortality and 30-day unplanned readmissions. Relative risks (RR) of outcomes were obtained using Poisson models with random intercept for hospital. Among 257,535 elderly inpatients, 33.6% had multimorbidity and elevated frailty risk, 14.7% had multimorbidity only, 19.9% had elevated frailty risk only and 31.8% had neither. Additive interactions were present for all outcomes, with a further multiplicative interaction for mortality and LOS. Mortality risk was 4.2 (95% CI 4.1-4.4), prolonged LOS 3.3 (95% CI 3.3-3.4) and readmission 1.8 (95% CI 1.7-1.9) times higher in patients with both factors present compared with patients with neither. In conclusion, multimorbidity and frailty coexist in older hospitalized patients and interact to increase the risk of adverse outcomes beyond the sum of their individual effects. Their joint effect should be considered in health outcomes research and when administering hospital resources.
Identifiants
pubmed: 35986045
doi: 10.1038/s41598-022-18346-x
pii: 10.1038/s41598-022-18346-x
pmc: PMC9391344
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
14139Informations de copyright
© 2022. The Author(s).
Références
Lancet. 2013 Mar 2;381(9868):752-62
pubmed: 23395245
BMJ. 2020 Feb 18;368:m160
pubmed: 32071114
J Intern Med. 2020 Mar;287(3):322-332
pubmed: 31661589
BMJ Qual Saf. 2019 Apr;28(4):284-288
pubmed: 30381331
J Gerontol A Biol Sci Med Sci. 2019 Jul 12;74(8):1265-1270
pubmed: 30169580
Epidemiol Rev. 2013;35:75-83
pubmed: 23372025
J Gerontol A Biol Sci Med Sci. 2019 Apr 23;74(5):659-666
pubmed: 29726918
BMJ. 2016 Sep 21;354:i4843
pubmed: 27655884
J Gerontol A Biol Sci Med Sci. 2001 Mar;56(3):M146-56
pubmed: 11253156
Med J Aust. 2020 Oct;213(7):321-326
pubmed: 32776351
J Clin Epidemiol. 2014 Mar;67(3):254-66
pubmed: 24472295
Lancet. 2018 May 5;391(10132):1775-1782
pubmed: 29706364
J Arthroplasty. 2020 Dec;35(12):3498-3504.e3
pubmed: 32800437
Am J Epidemiol. 2005 Aug 1;162(3):199-200
pubmed: 15987728
J Gerontol A Biol Sci Med Sci. 2011 Mar;66(3):301-11
pubmed: 21112963
J Comorb. 2019 Sep 09;9:2235042X19873486
pubmed: 31523633
J Gerontol A Biol Sci Med Sci. 2004 Mar;59(3):255-63
pubmed: 15031310
Am J Epidemiol. 2018 Nov 1;187(11):2470-2480
pubmed: 30060004
Age Ageing. 2021 Feb 26;50(2):511-518
pubmed: 32909030
Age (Dordr). 2014 Apr;36(2):923-31
pubmed: 24091565
Arch Gerontol Geriatr. 2016 Nov-Dec;67:130-8
pubmed: 27500661
BMJ Open. 2019 Jan 15;9(1):e026923
pubmed: 30647051
Age Ageing. 2020 Aug 24;49(5):716-722
pubmed: 32043136
Med Care. 2005 Nov;43(11):1130-9
pubmed: 16224307
Int J Epidemiol. 2012 Apr;41(2):514-20
pubmed: 22253321
J Comorb. 2019 Sep 04;9:2235042X19872030
pubmed: 31523632
JAMA. 1998 Nov 18;280(19):1690-1
pubmed: 9832001
J Frailty Aging. 2015;4(3):131-8
pubmed: 27030941
Med Care. 2020 Sep;58(9):815-825
pubmed: 32520767