1.2.1. Comorbilidad

 

1.2.1. Co-morbidity

MeSH: Comorbidity http://www.nlm.nih.gov/cgi/mesh/2008/MB_cgi?mode=&term=Comorbidity&field=entry

The presence of co-existing or additional diseases with reference to an initial diagnosis or with reference to the index condition that is the subject of study. Comorbidity may affect the ability of affected individuals to function and also their survival; it may be used as a prognostic indicator for length of hospital stay, cost factors, and outcome or survival. As an example, an individual could live with multiple chronic conditions such as paralysis, incontinence, dementia and pain, all stemming from a single disease like multiple sclerosis.

Comordibity could be classified in three groups depending on the relation between the index disease and the accompanying conditions:

  1. Random. These are the comorbidities that occur together with a frequency no different than the individual prevalences multiplied together, that is to say the associations occur by chance. An example in our practice is the co-existence of hand warts and osteoarthritis.
  2. Consequential (classified in the literature as casual or complicated co-morbidity). These are conditions that are pathophysiologically part of the same process. it is no surprise to find that diabetes and hypertension occur together more than by chance, so these co morbidities, though interesting, are predictable.
  3. Cluster co-morbidity is the non random clustering of health conditions without an evident underlying pathophysiological cause. Here is the opportunity for new discoveries - either new understandings of pathophysiology, or a new appreciation of the nature of complexity.

 

Contents related with this taxonomy

Los ingresos se reducen un 41% con una UIC para pluripatológicos
by dianagosalvez — 17/02/2011 09:52:58

Descripción según la fuente original: El Hospital Valle del Nalón, en Langreo, puso en marcha en 2006 una unidad de insuficiencia cardiaca (UIC) con pacientes pluripatológicos y gestionada por internistas

La esperanza de vida y el envejecimiento poblacional siguen creciendo en España
by dianagosalvez — 25/03/2011 12:50:20

Descripción según la fuente original: Según la última actualización de las Tablas de Mortalidad de España y sus regiones del Instituto Valenciano de Investigaciones Económicas (IVIE)...

Estudio cualitativo sobre multimorbilidad
by dianagosalvez — 29/01/2013 10:59:54

Descripción según la fuente original: O+berri, en colaboración con Prosumerlab, va a realizar un estudio cualitativo para recoger la opinión y experiencias de pacientes y de profesionales sanitarios de Euskadi en torno a la multimorbilidad, su vivencia y fenómenos relacionados como la polimedicación.

Según la SEMI, uno de cada seis adultos mayores de 15 años presenta un problema de salud crónico
by dianagosalvez — 15/11/2013 10:11:10

Descripción según la fuente original: Según la Sociedad Española de Medicina Interna, SEMI, en nuestro país uno de cada seis adultos mayores de 15 años presenta un problema de salud crónico, y en los mayores de 65 años la dependencia funcional alcanza al 46,5%, lo que aumenta progresivamente con la edad. En su Congreso Nacional, esta sociedad científica aborda dos importantes iniciativas para mejorar la asistencia sanitaria a los enfermos crónicos.

Evaluación de la comorbilidad en la población anciana: utilidad y validez de los instrumentos de medida.
by dianagosalvez — 10/04/2014 14:21:11

La comorbilidad es un problema frecuente en ancianos que contribuye a la complejidad de este grupo poblacional y supone un factor de riesgo de eventos adversos de salud (deterioro funcional, discapacidad, dependencia, institucionalización, hospitalización, mala calidad de vida y muerte), aunque no el principal. La comorbilidad entendida como una compilación de enfermedades no es la principal característica que define la población que debe ser atendida por un geriatra. La edad y el riesgo de declinar funcional deben primar sobre otras características.

Measures of Multimorbidity and Morbidity Burden for Use in Primary Care and Community Settings: A Systematic Review and Guide
by dianagosalvez — 9/05/2014 12:38:43

Many patients consulting in primary care have multiple conditions (multimorbidity). Aims of this review were to identify measures of multimorbidity and morbidity burden suitable for use in research in primary care and community populations, and to investigate their validity in relation to anticipated associations with patient characteristics, process measures, and health outcomes.

Multimorbidity and functional decline in community-dwelling adults: a systematic review
by dianagosalvez — 26/10/2015 16:19:35

Multimorbidity affects up to one quarter of primary care populations. It is associated with reduced quality of life, an increased risk of mental health difficulties and increased healthcare utilisation. Functional decline is defined as developing difficulties with activities of daily living and is independently associated with poorer health outcomes. The aim of this systematic review was to examine the association between multimorbidity and functional decline and to what extent multimorbidity predicts future functional decline.

Multimorbidity in older adults: magnitude and challenges for the Brazilian health system
by dianagosalvez — 4/02/2016 11:34:01

Multimorbidity is a public health problem with high prevalence and important consequences. The aim of this paper was to verify the prevalence and distribution of multimorbidity in Brazilian older adults.

Why the communicable/non-communicable disease dichotomy is problematic for public health control strategies: implications of multimorbidity for health systems in an era of health transition.
by dianagosalvez — 26/02/2016 11:22:51

In today's globalized world, rapid urbanization, mechanization of the rural economy, and the activities of trans-national food, drink and tobacco corporations are associated with behavioral changes that increase the risk of chronic non-communicable diseases (NCDs).

Análisis de coste-utilidad de un modelo de atención integrada a pacientes pluripatológicos basado en un ensayo clínico
by dianagosalvez — 29/09/2016 11:54:44

El objetivo de este artículo es evaluar en términos de coste-utilidad un modelo de atención integrada a pacientes pluripatológicos basado en el internista de referencia y la enfermera de enlace hospitalario, comparado con un sistema asistencial convencional reactivo por episodios.

Managing multimorbidity in primary care in patients with chronic respiratory conditions
by dianagosalvez — 6/10/2016 13:03:15

The term multimorbidity is usually defined as the coexistence of two or more chronic conditions within an individual, whereas the term comorbidity traditionally describes patients with an index condition and one or more additional conditions.

Methodology to Estimate the Longitudinal Average Attributable Fraction of Guideline-recommended Medications for Death in Older Adults With Multiple Chronic Conditions
by dianagosalvez — 6/10/2016 13:16:38

Persons with multiple chronic conditions receive multiple guideline-recommended medications to improve outcomes such as mortality. Our objective was to estimate the longitudinal average attributable fraction for 3-year survival of medications for cardiovascular conditions in persons with multiple chronic conditions and to determine whether heterogeneity occurred by age.

Utilidad del índice PROFUND para predecir la mortalidad a los 4 años en pacientes pluripatológicos
by dianagosalvez — 8/11/2016 15:33:52

El objetivo de este artículo es determinar la validez del índice PROFUND para establecer el riesgo de muerte global a los 4 años en pacientes pluripatológicos.

Frailty and multimorbidity: Two related yet different concepts
by dianagosalvez — 3/02/2017 13:42:56

The extension of life expectancy is a global phenomenon. The growth in the ageing population has created a new health scenario in which there is a higher prevalence of frailty and multimorbidity.

Development of an international comorbidity education framework
by dianagosalvez — 17/07/2017 13:50:50

The increasing number of people living with multiple chronic conditions in addition to an index condition has become an international healthcare priority. Health education curricula have been developed alongside single condition frameworks in health service policy and practice and need redesigning to incorporate optimal management of multiple conditions.

What is polypharmacy? A systematic review of definitions
by dianagosalvez — 19/10/2017 13:01:58

Multimorbidity and the associated use of multiple medicines (polypharmacy), is common in the older population. Despite this, there is no consensus definition for polypharmacy. A systematic review was conducted to identify and summarise polypharmacy definitions in existing literature.

International symposium: Multimorbidity research at the cross-roads: developing the evidence for clinical practice and health policy
by dianagosalvez — 24/01/2018 13:31:50

The International symposium was held in Stockholm on the 21st of May aboured the topic "Multimorbidity research at the cross-roads: developing the evidence for clinical practice and health policy".