Trajectories of chronic multimorbidity patterns in older patients

Multimorbidity is associated with negative results and poses difficulties in clinical management. New methodological approaches are emerging based on the hypothesis that chronic conditions are non-randomly associated forming multimorbidity patterns. However, there are few longitudinal studies of the...

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Autores: Lleal Custey, Marina|||0000-0002-0015-0725, Bare Mañas, Montserrat|||0000-0002-7243-3169, Herranz, Susana|||0000-0001-7049-8084, Orús Puigvert, Josefina|||0009-0007-5699-7515, Comet Monte, Ricard|||0000-0002-7352-779X, Jordana, Rosa|||0000-0002-2632-7672, Baré i Mañas, Marisa|||0000-0001-8085-2833
Formato: artículo
Fecha de publicación:2024
País:España
Recursos:Universitat Autònoma de Barcelona
Repositorio:Dipòsit Digital de Documents de la UAB
Idioma:inglés
OAI Identifier:oai:ddd.uab.cat:294937
Acesso em linha:https://ddd.uab.cat/record/294937
https://dx.doi.org/urn:doi:10.1186/s12877-024-04925-2
Access Level:acceso abierto
Palavra-chave:Ageing
Chronic conditions
Cluster analysis
Longitudinal study
Multimorbidity
Older patients
Trajectories
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spelling Trajectories of chronic multimorbidity patterns in older patientsMTOP studyLleal Custey, Marina|||0000-0002-0015-0725Bare Mañas, Montserrat|||0000-0002-7243-3169Herranz, Susana|||0000-0001-7049-8084Orús Puigvert, Josefina|||0009-0007-5699-7515Comet Monte, Ricard|||0000-0002-7352-779XJordana, Rosa|||0000-0002-2632-7672Baré i Mañas, Marisa|||0000-0001-8085-2833AgeingChronic conditionsCluster analysisLongitudinal studyMultimorbidityOlder patientsTrajectoriesMultimorbidity is associated with negative results and poses difficulties in clinical management. New methodological approaches are emerging based on the hypothesis that chronic conditions are non-randomly associated forming multimorbidity patterns. However, there are few longitudinal studies of these patterns, which could allow for better preventive strategies and healthcare planning. The objective of the MTOP (Multimorbidity Trajectories in Older Patients) study is to identify patterns of chronic multimorbidity in a cohort of older patients and their progression and trajectories in the previous 10 years. A retrospective, observational study with a cohort of 3988 patients aged > 65 was conducted, including suspected and confirmed COVID-19 patients in the reference area of Parc Taulí University Hospital. Real-world data on socio-demographic and diagnostic variables were retrieved. Multimorbidity patterns of chronic conditions were identified with fuzzy c-means cluster analysis. Trajectories of each patient were established along three time points (baseline, 5 years before, 10 years before). Descriptive statistics were performed together with a stratification by sex and age group. 3988 patients aged over 65 were included (58.9% females). Patients with ≥ 2 chronic conditions changed from 73.6 to 98.3% in the 10-year range of the study. Six clusters of chronic multimorbidity were identified 10 years before baseline, whereas five clusters were identified at both 5 years before and at baseline. Three clusters were consistently identified in all time points (Metabolic and vascular disease, Musculoskeletal and chronic pain syndrome, Unspecific); three clusters were only present at the earliest time point (Male-predominant diseases, Minor conditions and sensory impairment, Lipid metabolism disorders) and two clusters emerged 5 years before baseline and remained (Heart diseases and Neurocognitive). Sex and age stratification showed different distribution in cluster prevalence and trajectories. In a cohort of older patients, we were able to identify multimorbidity patterns of chronic conditions and describe their individual trajectories in the previous 10 years. Our results suggest that taking these trajectories into consideration might improve decisions in clinical management and healthcare planning. Trial registration number: NCT05717309.Universitat Autònoma de Barcelona. Departament de Pediatria, Obstetrícia i Ginecologia i de Medicina Preventiva i Salut Pública 22024-01-0120242024-01-01Articlehttp://purl.org/coar/resource_type/c_6501VoRhttp://purl.org/coar/version/c_970fb48d4fbd8a85info:eu-repo/semantics/articleapplication/pdfhttps://ddd.uab.cat/record/294937https://dx.doi.org/urn:doi:10.1186/s12877-024-04925-2reponame:Dipòsit Digital de Documents de la UABinstname:Universitat Autònoma de BarcelonaInglésengopen accesshttp://purl.org/coar/access_right/c_abf2Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.https://creativecommons.org/licenses/by/4.0/info:eu-repo/semantics/openAccessoai:ddd.uab.cat:2949372026-06-06T12:50:31Z
dc.title.none.fl_str_mv Trajectories of chronic multimorbidity patterns in older patients
MTOP study
title Trajectories of chronic multimorbidity patterns in older patients
spellingShingle Trajectories of chronic multimorbidity patterns in older patients
Lleal Custey, Marina|||0000-0002-0015-0725
Ageing
Chronic conditions
Cluster analysis
Longitudinal study
Multimorbidity
Older patients
Trajectories
title_short Trajectories of chronic multimorbidity patterns in older patients
title_full Trajectories of chronic multimorbidity patterns in older patients
title_fullStr Trajectories of chronic multimorbidity patterns in older patients
title_full_unstemmed Trajectories of chronic multimorbidity patterns in older patients
title_sort Trajectories of chronic multimorbidity patterns in older patients
dc.creator.none.fl_str_mv Lleal Custey, Marina|||0000-0002-0015-0725
Bare Mañas, Montserrat|||0000-0002-7243-3169
Herranz, Susana|||0000-0001-7049-8084
Orús Puigvert, Josefina|||0009-0007-5699-7515
Comet Monte, Ricard|||0000-0002-7352-779X
Jordana, Rosa|||0000-0002-2632-7672
Baré i Mañas, Marisa|||0000-0001-8085-2833
author Lleal Custey, Marina|||0000-0002-0015-0725
author_facet Lleal Custey, Marina|||0000-0002-0015-0725
Bare Mañas, Montserrat|||0000-0002-7243-3169
Herranz, Susana|||0000-0001-7049-8084
Orús Puigvert, Josefina|||0009-0007-5699-7515
Comet Monte, Ricard|||0000-0002-7352-779X
Jordana, Rosa|||0000-0002-2632-7672
Baré i Mañas, Marisa|||0000-0001-8085-2833
author_role author
author2 Bare Mañas, Montserrat|||0000-0002-7243-3169
Herranz, Susana|||0000-0001-7049-8084
Orús Puigvert, Josefina|||0009-0007-5699-7515
Comet Monte, Ricard|||0000-0002-7352-779X
Jordana, Rosa|||0000-0002-2632-7672
Baré i Mañas, Marisa|||0000-0001-8085-2833
author2_role author
author
author
author
author
author
dc.contributor.none.fl_str_mv Universitat Autònoma de Barcelona. Departament de Pediatria, Obstetrícia i Ginecologia i de Medicina Preventiva i Salut Pública
dc.subject.none.fl_str_mv Ageing
Chronic conditions
Cluster analysis
Longitudinal study
Multimorbidity
Older patients
Trajectories
topic Ageing
Chronic conditions
Cluster analysis
Longitudinal study
Multimorbidity
Older patients
Trajectories
description Multimorbidity is associated with negative results and poses difficulties in clinical management. New methodological approaches are emerging based on the hypothesis that chronic conditions are non-randomly associated forming multimorbidity patterns. However, there are few longitudinal studies of these patterns, which could allow for better preventive strategies and healthcare planning. The objective of the MTOP (Multimorbidity Trajectories in Older Patients) study is to identify patterns of chronic multimorbidity in a cohort of older patients and their progression and trajectories in the previous 10 years. A retrospective, observational study with a cohort of 3988 patients aged > 65 was conducted, including suspected and confirmed COVID-19 patients in the reference area of Parc Taulí University Hospital. Real-world data on socio-demographic and diagnostic variables were retrieved. Multimorbidity patterns of chronic conditions were identified with fuzzy c-means cluster analysis. Trajectories of each patient were established along three time points (baseline, 5 years before, 10 years before). Descriptive statistics were performed together with a stratification by sex and age group. 3988 patients aged over 65 were included (58.9% females). Patients with ≥ 2 chronic conditions changed from 73.6 to 98.3% in the 10-year range of the study. Six clusters of chronic multimorbidity were identified 10 years before baseline, whereas five clusters were identified at both 5 years before and at baseline. Three clusters were consistently identified in all time points (Metabolic and vascular disease, Musculoskeletal and chronic pain syndrome, Unspecific); three clusters were only present at the earliest time point (Male-predominant diseases, Minor conditions and sensory impairment, Lipid metabolism disorders) and two clusters emerged 5 years before baseline and remained (Heart diseases and Neurocognitive). Sex and age stratification showed different distribution in cluster prevalence and trajectories. In a cohort of older patients, we were able to identify multimorbidity patterns of chronic conditions and describe their individual trajectories in the previous 10 years. Our results suggest that taking these trajectories into consideration might improve decisions in clinical management and healthcare planning. Trial registration number: NCT05717309.
publishDate 2024
dc.date.none.fl_str_mv 2
2024-01-01
2024
2024-01-01
dc.type.none.fl_str_mv Article
http://purl.org/coar/resource_type/c_6501
VoR
http://purl.org/coar/version/c_970fb48d4fbd8a85
dc.type.openaire.fl_str_mv info:eu-repo/semantics/article
format article
dc.identifier.none.fl_str_mv https://ddd.uab.cat/record/294937
https://dx.doi.org/urn:doi:10.1186/s12877-024-04925-2
url https://ddd.uab.cat/record/294937
https://dx.doi.org/urn:doi:10.1186/s12877-024-04925-2
dc.language.none.fl_str_mv Inglés
eng
language_invalid_str_mv Inglés
language eng
dc.rights.none.fl_str_mv open access
http://purl.org/coar/access_right/c_abf2
https://creativecommons.org/licenses/by/4.0/
dc.rights.openaire.fl_str_mv info:eu-repo/semantics/openAccess
rights_invalid_str_mv open access
http://purl.org/coar/access_right/c_abf2
https://creativecommons.org/licenses/by/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.source.none.fl_str_mv reponame:Dipòsit Digital de Documents de la UAB
instname:Universitat Autònoma de Barcelona
instname_str Universitat Autònoma de Barcelona
reponame_str Dipòsit Digital de Documents de la UAB
collection Dipòsit Digital de Documents de la UAB
repository.name.fl_str_mv
repository.mail.fl_str_mv
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