Some aspects of comorbidity in hospitalized patients of a therapeutic hospital
https://doi.org/10.21626/vestnik/2020-2/03
Abstract
Objective - to analyze the risk factors (RF) of noncommunicable diseases depending on the comorbidity index (CI) in hospitalized patients.
Materials and methods. A cross-sectional study was performed at the Altai Regional Hospital for War Veterans. 128 people were invited to take part in the study during the month in the therapeutic department, 100 people agreed (78.1% response). The average age is 77.9±8.3 years, 48% of women, 52% of men. A general clinical examination, RF analysis of noncommunicable diseases, psychosocial factors, Montreal Cognitive Function Scale (MoCA test), and an examination by a neurologist to detect encephalopathy were performed. Based on the Charlson CI data, patients were divided into 3 groups: group 1 - CI 1-2 points - 46%, group 2 - CI 3-4 points - 38%, group 3 - CI 5 and more points - 16%.
Results. Regardless of gender, CI 5 or more was more common than CI 1-2 by 16.8%; among men, CI 5 and more occurred more often than CI 3-4 by 17.8%; middle-aged persons were only in the group with CI 1-2. In patients with CI 5 or more, compared with patients with CI 1-2, there was a higher frequency of such RFs as obesity (by 29.9%, all persons with CI 5 or more had abdominal obesity), social isolation (by 29.7%), type D personality (by 36.5%), as well as cognitive impairment (by 28.5%) and encephalopathy (by 32.9%). Depression was found 26.1% more often in patients with CI 3-4 than in patients with CI 1-2.
Conclusion. Comorbidity is not a mandatory condition characteristic of an aging population, it is primarily the result of individual behavior. Therefore, the identification and correction of RF of noncommunicable diseases, especially in conditions of comorbidity, seems to be an urgent task, which determines the success of treatment in this category of patients.
About the Authors
Natalia V. Pyrikova
Altai State Medical University
Russian Federation
DM, Associate Professor, Professor of Faculty Therapy and Occupational Diseases Department
Russian Federation
DM, Associate Professor, Professor of Faculty Therapy and Occupational Diseases Department
Oksana N. Antropova
Altai State Medical University
DM, Professor, Professor of Faculty Therapy and Occupational Diseases Department
DM, Professor, Professor of Faculty Therapy and Occupational Diseases Department
Irina V. Osipova
Altai State Medical University
DM, Professor, Head of Faculty Therapy and Occupational Diseases Department
DM, Professor, Head of Faculty Therapy and Occupational Diseases Department
Irina A. Frolova
Altai State Medical University
Student
Student
References
1. Belyalov F.I. Treatment of diseases in conditions of comorbidity. Moscow: GEOTAR-Media, 2016. 544 p. (in Russ.). DOI: 10.18087/cardio.n431
2. Boytsov S.A., Luk’yanov M.M., Yakushin C.S., Martsevich S.Yu., Vorob’yev A.N., Zagrebel’nyy A.V., Pereverzeva K.G., Pravkina E.A., et al. The outpatient based registry RECVASA: prospective follow-up data, risk evaluation and outcomes in cardiovascular patients. Cardiovascular therapy and prevention. 2015;14(1):53-62 (in Russ.). DOI: 10.15829/1728-8800-2015-1-53-62
3. Boytsov S.A., Pogosova N.V., Bubnova M.G., Drapkina O.M., Gavrilova N.E., Eganyan R.A., Kalinina A.M., Karamnova N.S., et al. Cardiovascular prophylaxis 2017. Russian national recommendations. Russian journal of cardiology. 2018;23(6):7-122 (in Russ.). DOI: 10.15829/1560-4071-2018-6-7-122
4. Efremova E.V., Shutov A.M., Borodulina E.O. Problem of comorbidity in chronic heart failure. Ulyanovsky medico-biological journal. 2015;4:46-52 (in Russ.).
5. Larina V.N., Bart B.Ya., Karpenko D.G., Starostin I.V., Larin V.G., Kulbachinskaya O.M. Polymorbidity and its association with the unfavorable course of chronic heart failure in outpatients aged 60 years and older. Kardiologiia. 2019;59(12S):25-36 (in Russ.). DOI: 10.18087/cardio.n431
6. Mad’yanova V.V, Kakorina E.P., Klokova T.A. The characteristics of morbidity of population older than able-bodied age in the Russian federation in 2012-2018. Problems of social hygiene, public health and history of medicine, Russian journal. 2020;28(2):207-215 (in Russ.).
7. Mal’chikova S.V., Maksimchuk-Kolobova N.S., Kazakovtseva M.V. Comorbidity in elderly patients with atrial fibrillation affects the "cost of illness". Farmakoekonomika. Modern pharmacoeconomic and pharmacoepidemiology. 2019;12(3):191-199 (in Russ.). DOI: 10.17749/2070-4909.2019.12.3.191-199
8. Mamedov M.N., Zvolinskaya E.Yu., Akhmedova E.B., SHepel’ R.N. The basic principles of lifestyle changes in patients with comorbidity CNID. Oganov R.G., Drapkina O.M., editors. Moscow, 2018. 126 р. (in Russ.). DOI: 10.17116/profmed2018rekcomorbidity
9. Nizov A.A., Suchkova E.I., Dashkevich O.V., Trunina T.P. Cardiovascular comorbidity in the actual clinical practice of an outpatient physician. Comparative register study in the Ryazan Region. Cardiovascular therapy and prevention. 2019;18(2):70-75 (in Russ.). DOI: 10.15829/1728-8800-2019-2-70-75
10. Oganov R.G., Simanenkov V.I., Bakulin I.G., Bakulina N.V., Barbarash O.L., Boytsov S.A., Boldueva S.A., Garganeeva N.P., et al. Comorbid pathology in clinical practice. Diagnostic and treatment algorithms. Cardiovascular therapy and prevention. 2019;18(1): 5-66 (in Russ.). DOI: 10.15829/1728-8800-2019-1-5-66
11. Orlova Ya.A., Tkacheva O.N., Arutyunov G.P., Kotovskaya Yu.V., Lopatin Yu.M., Mareyev V.Yu., Mareyev Yu.V., Runikhina N.K., et al. Features of diagnostics and treatment of chronic heart failure in elderly and senile patients. Expert opinion of the Society of Experts in Heart Failure, Russian Association of Gerontologists, and Euroasian Association of Therapists. Kardiologiia. 2018;58(12S):42-72 (in Russ.). DOI: 10.18087/cardio.2560
12. Sarsenbayeva G.I., Tursynbekova A.E. Modern approaches to the assessment of comorbidity in patients. CardioSomatics. 2019;10(1):19-23 (in Russ.). DOI: 10.26442/22217185.2018.4.180073
13. Starodubova A.V., Varayeva Yu.R., Egorova V.V., Brumberg A.A. The principles of nutrition for the elderly. Moskovskaya meditsina. 2019;2(30):36-41 (in Russ.).
14. Tkacheva O.N., Runikhina N.K., Kotovskaya Yu.V., Sharashkina N.V., Ostapenko V.S. Arterial hypertension management in patients aged older than 80 years and patients with the senile asthenia. Cardiovascular therapy and prevention. 2017;16(1):8-21 (in Russ.). DOI: 10.15829/1728-8800-2017-1-8-21
15. Tkacheva O.N., Runikhina N.K., Ostapenko V.S., Sharashkina N.V., Mkhitaryan E.A., Onuchina Yu.S., Lysenkov S.N. Validation of the questionnaire for screening frailty. Advances in gerontology. 2017;30(2):236-242.
16. Frolova E.V. The clinical features of heart failure in elderly and old age. Kardiologiia. 2018;58(S8):4-11 (in Russ.). DOI: 10.18087/cardio.2487
17. Buta B.J., Walston J.D., Godino J.G., Park M., Kalyani R.R., Xue Q-L., Bandeen-Roche K., Varadhan R. Frailty assessment instruments: systematic characterization of the uses and contexts of highly - cited instruments. Ageing Res Rev. 2016;26:53-61. DOI: 10.1016/j.arr.2015.12.003
18. Charlson M.E., Pompei P., Ales K.L., MacKenzie C.R. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis. 1987;40:373-383. DOI: 10.1016/0021-9681(87)90171-8
19. DuGoff E.H., Canudas-Romo V., Buttorff C., Leff В., Anderson G.F. Multiple chronic conditions and life expectancy: a life table analysis. Med Care. 2014;52(8):688-694. DOI: 10.1097/MLR.0000000000000166
20. Forman D.E., Arena R., Boxer R., Dolansky M.A., Eng J.J., Fleg J.L., Haykowsky M., Jahangir A., et al. Prioritizing functional capacity as a principal end point for therapies oriented to older adults with cardiovascular disease: a scientific statement for healthcare professionals from the American Heart Association. Circulation. 2017;135(16):e894-918. DOI: 10.1161/CIR.0000000000000483
21. Nasreddine Z.S., Phillips N.A., Bederian V., Charbonneau S., Whitehead V., Collin I., Cummings J.L., Chertkow H. The Montreal cognitive assessment (MoCA): a brief screening tool for mild cognitive impairment. J Am Geriatr Soc. 2005;53:695-699. DOI: 10.1111/j.1532-5415.2005.53221.x
22. Piepoli M.F., Hoes A.W., Agewall S., Albus C., Brotons C., Catapano F.L., Cooney M-T., Corra U., et al. 2016 European Guidelines on cardiovascular disease prevention in clinical practice: The Sixth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of 10 societies and by invited experts). Developed with the special contribution of the European Association for Cardiovascular Prevention & Rehabilitation (EACPR). Eur Heart J. 2016;37(29):2315-2381. DOI:10.1093/eurheartj/ehw106
23. Vasan R.S., Xanthakis V., Lyass A., Andersson C., Tsao C., Cheng S., Aragam J., Benjamin E.J., Larson M.J. Epidemiology of Left Ventricular Systolic Dysfunction and Heart Failure in the Framingham Study. JACC: Cardiovascular Imaging. 2018;11(1): 1-11. DOI: 10.1016/j.jcmg.2017.08.007
24. Vermeiren S., Vella-Azzopardi R., Beckwée D., Habbig A-K., Scafoglieri A., Jansen B., Bautmans I. Frailty and the Prediction of Negative Health Outcomes: A Meta-Analysis. J Am Med Dir Assoc. 2016;17(12):1163.e1-1163.el7. DOI: 10.1016/j.jamda.2016.09.010
Review
For citations:
Pyrikova N.V., Antropova O.N., Osipova I.V., Frolova I.A. Some aspects of comorbidity in hospitalized patients of a therapeutic hospital. Kursk Scientific and Practical Bulletin "Man and His Health". 2020;(2):16-26. (In Russ.) https://doi.org/10.21626/vestnik/2020-2/03
Views:
448
Email this article 