Abstract
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 1-5 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 two of ten diagnosis groups: lung, musculoskeletal, endocrine, mental, cancer, neurological, gastrointestinal, cardiovascular, kidney, and sensory organs. Logistic regression (odds ratios, OR) 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 (0.4%) was the musculoskeletal-cardiovascular 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, i.e. were additive rather than synergistic.
Objective: To determine the nationwide prevalence of multimorbidity and estimate mortality for the most prevalent combinations of 1-5 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 two of ten diagnosis groups: lung, musculoskeletal, endocrine, mental, cancer, neurological, gastrointestinal, cardiovascular, kidney, and sensory organs. Logistic regression (odds ratios, OR) 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 (0.4%) was the musculoskeletal-cardiovascular 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, i.e. were additive rather than synergistic.
| Originalsprog | Engelsk |
|---|---|
| Artikelnummer | 8 |
| Tidsskrift | Journal of Comorbidity |
| Vol/bind | 8 |
| Sider (fra-til) | 1-9 |
| Antal sider | 9 |
| ISSN | 2235-042X |
| DOI | |
| Status | Udgivet - 2018 |
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