000087021 001__ 87021
000087021 005__ 20231027130638.0
000087021 0247_ $$2doi$$a10.1136/bmjopen-2019-033174
000087021 0248_ $$2sideral$$a115362
000087021 037__ $$aART-2019-115362
000087021 041__ $$aeng
000087021 100__ $$0(orcid)0000-0002-5440-1710$$aGimeno Miguel, Antonio
000087021 245__ $$aMultimorbidity patterns in patients with heart failure: an observational Spanish study based on electronic health records
000087021 260__ $$c2019
000087021 5060_ $$aAccess copy available to the general public$$fUnrestricted
000087021 5203_ $$aObjectives To characterise the comorbidities of heart failure (HF) in men and women, to explore their clustering into multimorbidity patterns, and to measure the impact of such patterns on the risk of hospitalisation and mortality.
Design Observational retrospective population study based on electronic health records.
Setting EpiChron Cohort (Aragón, Spain).
Participants All the primary and hospital care patients of the EpiChron Cohort with a diagnosis of HF on 1 January 2011 (ie, 8488 women and 6182 men). We analysed all the chronic diseases registered in patients’ electronic health records until 31 December 2011.
Primary outcome We performed an exploratory factor analysis to identify the multimorbidity patterns in men and women, and logistic and Cox proportional-hazards regressions to investigate the association between the patterns and the risk of hospitalisation in 2012, and of 3-year mortality.
Results Almost all HF patients (98%) had multimorbidity, with an average of 7.8 chronic diseases per patient. We identified six different multimorbidity patterns, named cardiovascular, neurovascular, coronary, metabolic, degenerative and respiratory. The most prevalent were the degenerative (64.0%) and cardiovascular (29.9%) patterns in women, and the metabolic (49.3%) and cardiovascular (43.2%) patterns in men. Every pattern was associated with higher hospitalisation risks; and the cardiovascular, neurovascular and respiratory patterns significantly increased the likelihood of 3-year mortality.
Conclusions Multimorbidity is the norm rather than the exception in patients with heart failure, whose comorbidities tend to cluster together beyond simple chance in the form of multimorbidity patterns that have different impact on health outcomes. This knowledge could be useful to better understand common pathophysiological pathways underlying this condition and its comorbidities, and the factors influencing the prognosis of men and women with HF. Further large scale longitudinal studies are encouraged to confirm the existence of these patterns as well as their differential impact on health outcomes.
000087021 536__ $$9info:eu-repo/grantAgreement/ES/DGA-FEDER/B01-17R
000087021 540__ $$9info:eu-repo/semantics/openAccess$$aby-nc$$uhttp://creativecommons.org/licenses/by-nc/3.0/es/
000087021 590__ $$a2.496$$b2019
000087021 591__ $$aMEDICINE, GENERAL & INTERNAL$$b52 / 165 = 0.315$$c2019$$dQ2$$eT1
000087021 592__ $$a1.247$$b2019
000087021 593__ $$aMedicine (miscellaneous)$$c2019$$dQ1
000087021 655_4 $$ainfo:eu-repo/semantics/article$$vinfo:eu-repo/semantics/publishedVersion
000087021 700__ $$aGracia Gutiérrez, Anyuli
000087021 700__ $$aPoblador Plou, Beatriz
000087021 700__ $$aCoscollar Santaliestra, Carlos
000087021 700__ $$0(orcid)0000-0003-2361-9941$$aPérez Calvo, J. Ignacio$$uUniversidad de Zaragoza
000087021 700__ $$aDivo, Miguel J.
000087021 700__ $$aCalderón Larrañaga, Amaia
000087021 700__ $$0(orcid)0000-0002-5704-6056$$aPrados Torres, Alexandra
000087021 700__ $$0(orcid)0000-0002-5172-0388$$aRuiz Laiglesia, Fernando J.$$uUniversidad de Zaragoza
000087021 7102_ $$11007$$2610$$aUniversidad de Zaragoza$$bDpto. Medicina, Psiqu. y Derm.$$cArea Medicina
000087021 773__ $$g9, 12 (2019), e033174 [9 pp.]$$pBMJ Open$$tBMJ Open$$x2044-6055
000087021 8564_ $$s335562$$uhttps://zaguan.unizar.es/record/87021/files/texto_completo.pdf$$yVersión publicada
000087021 8564_ $$s126616$$uhttps://zaguan.unizar.es/record/87021/files/texto_completo.jpg?subformat=icon$$xicon$$yVersión publicada
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000087021 951__ $$a2023-10-27-12:53:18
000087021 980__ $$aARTICLE