Multicomorbidity of chronic diseases and substance use disorders and their association with hospitalization: Results from electronic health records data
Multicomorbidity of chronic diseases and substance use disorders and their association with hospitalization: Results from electronic health records data
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DOI：
10.1016/j.drugalcdep.2018.08.013
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发表时间：
2018-11-01
影响因子：
4.2
通讯作者：
Ghitza, Udi E.
中科院分区：
文献类型：
--
作者：
Wu, Li-Tzy;Zhu, He;Ghitza, Udi E.
背景：慢性病是一种普遍存在的疾病，也是导致死亡的主要原因。物质使用障碍（SUDs）和慢性疾病的共病是understudied告知行为healthcare integration.Objectives：本研究利用电子健康记录（EHR）数据的211,880成年人从一个大型卫生系统检查SUDs和9个慢性疾病组的共病的患病率和相关性，并确定其与住院。方法：进行Logistic回归分析，以估计慢性疾病和SUD之间的关联。为了控制诊断的严重程度，SUD和住院之间的相关性分析按慢性疾病的数量分层。在样本中，48.3%有>= 1种慢性疾病（高血压33.7%，关节炎16.2%，糖尿病13.7%，慢性肾病9.9%，哮喘9.1%，慢性阻塞性肺病8.9%，缺血性心脏病8.3%，癌症4.6%，肝炎1.3%）。患者中SUD的患病率（总体为13.3%）随着多种慢性疾病的增加而增加（患有一种疾病的患者中，14.3%患有SUD;患有两到三种疾病的患者中，21.2%患有SUD;患有4-9种疾病的患者中，32.5%患有SUD）。慢性疾病与SUD的几率增加相关。对于所有的SUD组，住院治疗的SUD患者比那些没有它的患病率增加的住院治疗的并发症的慢性conditions.Conclusions的数量：调查结果揭示了一个惊人的模式，多合并症的SUD和慢性疾病，其正相关的住院治疗。行为医疗保健整合应考虑评估和治疗SUD和慢性病共病的努力，特别是在患有多种慢性疾病的成年人中。
Background: Chronic diseases are prevalent and the leading causes of mortality. Comorbidity of substance use disorders (SUDs) and chronic diseases is understudied to inform behavioral healthcare integration.Objectives: This study leveraged electronic health record (EHR) data of 211,880 adults from a large health system to examine prevalence and correlates of comorbidity of SUDs and nine chronic disease groups and to determine their association with hospitalization.Methods: Logistic regression analyses were conducted to estimate associations between chronic diseases and SUDs. To control for severity of diagnosis, analyses of associations between SUD and hospitalization were stratified by the number of chronic conditions.Results: In the sample, 48.3% had >= 1 chronic condition (hypertension 33.7%, arthritis 16.2%, diabetes 13.7%, chronic kidney disease 9.9%, asthma 9.1%, chronic obstructive pulmonary disease 8.9%, ischemic heart disease 8.3%, cancer 4.6%, and hepatitis 1.3%). Prevalence of SUD (overall 13.3%) among patients increased with multiple chronic conditions (14.3% having SUD among patients with one condition; 21.2% having SUD among patients with two to three conditions; and 32.5% having SUD among patients with 4-9 conditions). Chronic conditions were associated with increased odds of SUDs. For all SUD groups, hospitalization was more prevalent among patients with SUD than those without it; prevalence of hospitalization increased with the number of comorbid chronic conditions.Conclusions: Findings reveal a striking pattern of multicomorbidity of SUD and chronic diseases and its positive association with hospitalization. Behavioral healthcare integration should consider efforts to assess and treat comorbid SUD and chronic diseases, especially among adults with multiple chronic conditions.