Complex multimorbidity and mortality in Japan: a prospective propensity-matched cohort study.
Complex multimorbidity and mortality in Japan: a prospective propensity-matched cohort study.
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DOI：
10.1136/bmjopen-2020-046749
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发表时间：
2021-08-02
期刊：
影响因子：
2.9
通讯作者：
Kondo N
中科院分区：
文献类型：
--
作者：
Kato D;Kawachi I;Saito J;Kondo N
根据简单的疾病计数来定义多发性骨髓瘤（MM）有其局限性。为了解决这些局限性，复杂MM（CMM）的概念侧重于单个患者中有多少身体系统受到影响，而不是计算合并症。本研究比较了CMM和传统MM对日本老年人死亡率的预测。一项基于人群的前瞻性队列研究。日本老年学评估研究，一项全国性的纵向队列研究，从2010年到2016年。年龄超过65岁且在基线调查时具有完整疾病数据的功能独立个体符合资格。CMM定义为基线时3种或3种以上身体系统疾病共存。我们根据各种特征，包括社会经济地位和健康行为，计算了每个人发展CMM的倾向。在我们使用对数秩检验估计总生存率之前，将患有和未患有CMM的个体的倾向评分进行匹配。我们的6年随访包括38889名老年人：分别有20233名（52.0%）和7565名（19.5%）MM和CMM成人。在MM匹配队列（n=15 666对）中，MM的存在与死亡率增加显著相关（HR 1.07; 95% CI 1.01 - 1.14;对数秩检验p=0.02）。在CMM匹配队列中发现了类似的死亡率相关性（n=7524对，HR，1.07; 95% CI 0.99至1.16;对数秩检验p=0.08）。这是第一项报告日本老年人CMM与死亡率之间关系的研究。MM和CMM预测老年人死亡率的程度相似。这一发现需要在更大的样本中更精确地重复。
There are limitations to defining multimorbidity (MM) based on a simple count of diseases. To address these limitations, the concept of complex MM (CMM) focuses on how many body systems are affected in a single patient, rather than counting comorbid conditions. This study compared the prediction of mortality among older Japanese adults between CMM and conventional MM. A population-based prospective cohort study. The Japan Gerontological Evaluation Study, a nationwide longitudinal cohort study, which ran from 2010 to 2016. Functionally independent individuals who were older than 65 and had complete illness data at the time of baseline survey were eligible. CMM was defined as the coexistence of 3 or more body system disorders at baseline. We calculated the propensity for each individual to develop CMM based on a wide array of characteristics, including socioeconomic status and health behaviours. Individuals with and without CMM were then matched on their propensity scores before we estimated overall survival using a log-rank test. Our 6-year follow-up included 38 889 older adults: 20 233 (52.0%) and 7565 (19.5%) adults with MM and CMM, respectively. In the MM-matched cohort (n=15 666 pairs), the presence of MM was significantly associated with increased mortality (HR 1.07; 95% CI 1.01 to 1.14; p=0.02 by the log-rank test). A similar mortality association was found in the CMM-matched cohort (n=7524 pairs, HR, 1.07; 95% CI 0.99 to 1.16; p=0.08 by the log-rank test). This is the first study to report the association between CMM and mortality among older adults in Japan. MM and CMM predict mortality in older adults to a similar degree. This finding needs to be replicated with more precision in larger samples.
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影响因子：
4.7
作者：
Kondo K
通讯作者：
Kondo K
DOI：
10.1111/j.1532-5415.1968.tb02103.x
发表时间：
1968-01-01
影响因子：
6.3
作者：
LINN, BS;LINN, MW;GUREL, L
通讯作者：
GUREL, L
影响因子：
2.9
作者：
Vinjerui, Kristin Hestmann;Bjerkeset, Ottar;Sund, Erik R.
通讯作者：
Sund, Erik R.
DOI：
10.1111/1753-6405.12509
发表时间：
2016-06-01
影响因子：
3.5
作者：
Harrison, Christopher;Henderson, Joan;Britt, Helena
通讯作者：
Britt, Helena
澳大利亚的多种病态：比较使用管理数据源和调查数据得出的估计值。
影响因子：
3.7
作者：
Lujic S;Simpson JM;Zwar N;Hosseinzadeh H;Jorm L
通讯作者：
Jorm L