Simple approaches to characterising multiple long-term conditions (multimorbidity) and rates of emergency hospital admission: Findings from 495,465 UK Biobank participants.
Simple approaches to characterising multiple long-term conditions (multimorbidity) and rates of emergency hospital admission: Findings from 495,465 UK Biobank participants.
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DOI：
10.1111/joim.13567
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发表时间：
2023-01
影响因子：
11.1
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中科院分区：
文献类型：
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许多方法被用来验证多个长期条件（MLTC），包括计数和指数。很少有研究在同一数据集内比较方法。我们的目的是使用简单的方法来评估MLTC，并比较他们对MLTC的患病率估计以及与英国生物库中急诊入院的相关性。我们使用了495，465名参与者（年龄38-73岁）的基线数据，使用四种方法进行MLTC评估：Charlson指数（CI），Byles指数（BI），43种疾病计数（CC）和受影响的身体系统计数（BC）。我们将MLTC定义为使用CI，BI和CC的两种以上条件，以及使用BC的两种以上身体系统。我们将每种方法的得分（包括指数的权重）分为0，1，2和3+。我们使用了相关的医院事件统计数据，并进行了生存分析，以检验与5年内急诊入院或死亡终点的相关性。MLTC的患病率分别为44%（BC）、33%（CC）、6%（BI）和2%（CI）。使用所有方法的较高分数与较高的结局率相关，与性别和年龄组无关。例如，使用CC，与评分0相比，评分2的结局率为1.95（95% CI：1.91，1.99），评分3+的结局率为3.12（95% CI：3.06，3.18）倍。所有方法的判别值都是中等的（C统计量0.60-0.63）。计数分类为患有MLTC的比例高于指数，突出表明MLTC的流行率估计值因方法而异。所有方法与急诊入院有很强的统计学关联，但识别风险个体的能力有限。
Numerous approaches are used to characterise multiple long‐term conditions (MLTC), including counts and indices. Few studies have compared approaches within the same dataset. We aimed to characterise MLTC using simple approaches, and compare their prevalence estimates of MLTC and associations with emergency hospital admission in the UK Biobank. We used baseline data from 495,465 participants (age 38–73 years) to characterise MLTC using four approaches: Charlson index (CI), Byles index (BI), count of 43 conditions (CC) and count of body systems affected (BC). We defined MLTC as more than two conditions using CI, BI and CC, and more than two body systems using BC. We categorised scores (incorporating weightings for the indices) from each approach as 0, 1, 2 and 3+. We used linked hospital episode statistics and performed survival analyses to test associations with an endpoint of emergency hospital admission or death over 5 years. The prevalence of MLTC was 44% (BC), 33% (CC), 6% (BI) and 2% (CI). Higher scores using all approaches were associated with greater outcome rates independent of sex and age group. For example, using CC, compared with score 0, score 2 had 1.95 (95% CI: 1.91, 1.99) and a score of 3+ had 3.12 (95% CI: 3.06, 3.18) times greater outcome rates. The discriminant value of all approaches was modest (C‐statistics 0.60–0.63). The counts classified a greater proportion as having MLTC than the indices, highlighting that prevalence estimates of MLTC vary depending on the approach. All approaches had strong statistical associations with emergency hospital admission but a modest ability to identify individuals at risk.
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影响因子：
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作者：
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通讯作者：
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