Identifying longitudinal clusters of multimorbidity in an urban setting: A population-based cross-sectional study.
Identifying longitudinal clusters of multimorbidity in an urban setting: A population-based cross-sectional study.
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DOI：
10.1016/j.lanepe.2021.100047
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发表时间：
2021-04
期刊：
影响因子：
--
通讯作者：
Wang Y
中科院分区：
文献类型：
--
作者：
Bisquera A;Gulliford M;Dodhia H;Ledwaba-Chapman L;Durbaba S;Soley-Bori M;Fox-Rushby J;Ashworth M;Wang Y
在全球范围内，对多发病集群的研究越来越多，但很少有研究调查以年轻、多种族、贫困人口为特征的城市背景下的多发病。本研究确定了城市环境中的关联多病集群。这是一项以人群为基础的回顾性横断面研究，使用了2005年4月至2020年5月在伦敦一个行政区的全科诊所登记的所有18岁及以上成年人的电子健康记录。采用多重对应分析和聚类分析来确定32例长期疾病（LTCs）的多病组。人群包括41名全科医生，826,936名2005 - 2020年登记的患者，平均年龄40岁（sd15.6）。多病患病率为21% (n = 174,881)，中位数为三种，并随着年龄的增长而增加。分析确定了五个一致的LTC集群：1)焦虑和抑郁(平方和内与间之比（WSS/BSS < 0.01至< 0.01）；2)心力衰竭、心房颤动、慢性肾病（CKD）、慢性心脏病（CHD）、脑卒中/短暂性缺血发作（TIA）、外周动脉疾病（PAD）、痴呆和骨质疏松症（WSS/BSS 0.09 ~ 0.12）；3)骨关节炎、癌症、慢性疼痛、高血压和糖尿病（0.05 ~ 0.06）；4)慢性肝病和病毒性肝炎（WSS/BSS 0.02 ~ 0.03）；5)物质依赖、酒精依赖与HIV （WSS/BSS 0.37 ~ 0.55）。精神健康问题、疼痛和导致心血管疾病的危险行为是这一年轻城市人口中确定的重要群体。对城市卫生的影响，联合王国。
Globally, there is increasing research on clusters of multimorbidity, but few studies have investigated multimorbidity in urban contexts characterised by a young, multi-ethnic, deprived populations. This study identified clusters of associative multimorbidity in an urban setting. This is a population-based retrospective cross-sectional study using electronic health records of all adults aged 18 years and over, registered between April 2005 to May 2020 in general practices in one inner London borough. Multiple correspondence analysis and cluster analysis was used to identify groups of multimorbidity from 32 long-term conditions (LTCs). The population included 41 general practices with 826,936 patients registered between 2005 and 2020, with mean age 40 (SD15·6) years. The prevalence of multimorbidity was 21% (n = 174,881), with the median number of conditions being three and increasing with age. Analysis identified five consistent LTC clusters: 1) anxiety and depression (Ratio of within- to between- sum of squares (WSS/BSS <0·01 to <0·01); 2) heart failure, atrial fibrillation, chronic kidney disease (CKD), chronic heart disease (CHD), stroke/transient ischaemic attack (TIA), peripheral arterial disease (PAD), dementia and osteoporosis (WSS/BSS 0·09 to 0·12); 3) osteoarthritis, cancer, chronic pain, hypertension and diabetes (0·05 to 0·06); 4) chronic liver disease and viral hepatitis (WSS/BSS 0·02 to 0·03); 5) substance dependency, alcohol dependency and HIV (WSS/BSS 0·37 to 0·55). Mental health problems, pain, and at-risk behaviours leading to cardiovascular diseases are the important clusters identified in this young, urban population. Impact on Urban Health, United Kingdom.
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