Mortality rate in veterans with multiple chronic conditions
Mortality rate in veterans with multiple chronic conditions
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DOI：
10.1007/s11606-007-0277-2
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发表时间：
2007-12-01
影响因子：
5.7
通讯作者：
Weiss, Kevin B.
中科院分区：
文献类型：
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作者：
Lee, Todd A.;Shields, Alexandra E.;Weiss, Kevin B.
背景：在患有多种慢性疾病的患者中，人们越来越认识到疾病之间复杂的相互关系。以前的研究集中在与多种慢性病的患病率和经济负担，少得多是已知的死亡率与特定组合的多种diseases.OBJECTIVE：测量死亡率的组合11慢性条件。参与者：1999年10月至2000年9月使用退伍军人健康管理局卫生保健服务的55至64岁退伍军人。测量值：患者被确定为患有以下一种或多种疾病：COPD、糖尿病、高血压、类风湿性关节炎、骨关节炎、哮喘、抑郁症、缺血性心脏病、痴呆、中风和癌症。根据这些条件建立相互排斥的疾病组合，并确定5年死亡率。结果：包括741，847人。根据疾病计数，每组的数量为：无= 217，944（29.34%）; 1= 221，111（29.8%）; 2= 175，228（23.6%）; 3= 86，447（11.7%）; 4+= 41，117（5.5%）。按疾病数量划分的5年死亡率为：无=4.1%; 1=6.0%; 2=7.8%; 3=11.2%; 4+= 16.7%。在具有相同数量条件的组合中，死亡率存在显著差异。结论：患有多种慢性疾病的患者死亡率较高。由于具有相同数量条件的群集之间的死亡率存在显着差异，因此在研究患有多种共存疾病的患者时，重要的是要了解不仅可能存在多种条件，而且特定条件可能会对死亡风险产生差异性影响。
BACKGROUND: Among patients with multiple chronic conditions, there is increasing appreciation of the complex interrelatedness of diseases. Previous studies have focused on the prevalence and economic burden associated with multiple chronic conditions, much less is known about the mortality rate associated with specific combinations of multiple diseases.OBJECTIVE: Measure the mortality rate in combinations of 11 chronic conditions.DESIGN. Cohort study of veteran health care users.PARTICIPANTS: Veterans between 55 and 64 years that used Veterans Health Administration health care services between October 1999 and September 2000. MEASUREMENTS: Patients were identified as having one or more of the following: COPD, diabetes, hypertension, rheumatoid arthritis, osteoarthritis, asthma, depression, ischemic heart disease, dementia, stroke, and cancer. Mutually exclusive combinations of disease based on these conditions were created, and 5-year mortality rates were determined.RESULTS: There were 741,847 persons included. The number in each group by a count of conditions was: none = 217,944 (29.34%): 1=221,111 (29.8%); 2=175,228 (23.6%); 3=86,447 (11.7%); and 4+=41,117 (5.5%). The 5-year mortality rate by the number of conditions was: none=4.1%; 1=6.0%; 2=7.8%; 3=11.2%; 4+=16.7%. Among combinations with the same number of conditions, there was significant variability in mortality rates.CONCLUSIONS: Patients with multiple chronic conditions have higher mortality rates. Because there was significant variation in mortality across clusters with the same number of conditions, when studying patients with multiple coexisting illnesses, it is important to understand not only that several conditions may be present but that specific conditions can differentially impact the risk of mortality.