高龄老年住院患者1004例慢性病共病特点分析

Characteristics of multimorbidity on chronic diseases in very old inpatients:report of 1004 cases

摘要:

目的 了解高龄老年住院患者慢性病种类、慢性共病类型及其分布特点。方法 统计2013年6月至2016年6月期间于武汉大学中南医院老年病科住院的1004例高龄老年患者的疾病信息,筛选出23种慢性疾病,对慢性病类型及慢性共病特点进行统计分析。计数资料采用卡方检验；计量资料采用t检验或单因素方差分析。结果 23种慢性病中患病率最高的前5位疾病分别为高血压(72.51%)、脑血管病(52.29%)、冠心病(37.25%)、心功能不全(36.25%)及骨关节病(33.96%)。93.73%的高龄老人患有两种或两种以上的慢性疾病,平均慢性共病为(4.67±2.18)种。将慢性病两两组合成疾病对,特定疾病对的实际共同患病率较理论患病率高,如高血压与糖尿病(OR=1.25, 95%CI 1.02~1.54；P=0.03)、冠心病与心功能不全(OR=2.14, 95%CI 1.69~2.69；P<0.01)、心功能不全与心律失常(OR=1.77, 95%CI 1.34~2.35；P<0.01)。结论 高龄老年人群共病患者呈现高患病率、平均共病个数较多的特点。慢性病之间相互联系组合可形成特定的疾病对。

Abstract:

Objective To investigate the types of chronic diseases and distributions and patterns of multimorbidity in the very old inpatients. Methods Clinical data of 1004 elderly hospitalized patients in the Department of Geriatrics of our hospital from June 2013 to June 2016 were collected and retrospectively analyzed. Based on the presence of 23 common chronic conditions, types of these diseases and characteristics of chronic comorbidities were investigated. Student’s t test or one-way analysis of variance was employed for statistical analysis in measure data, and Chi-square test was used for enumeration data.Results Among the 23 obtained chronic diseases, the top 5 common ones were hypertension (72.51%), cerebrovascular disease (52.29%), coronary heart disease (37.25%), cardiac insufficiency (36.25%), and bone and joint disease (33.96%). The rate of multimorbidity (≥2 disease) was 93.73% in the cohort, and the mean number of comorbid conditions was (4.67±2.18). The observed prevalence of paired chronic conditions exceeded the expected prevalence for several paired conditions, such as hypertension and diabetes mellitus(OR=1.25, 95%CI 1.02-1.54; P=0.03), coronary heart disease and cardiac insufficiency(OR=2.14, 95%CI 1.69-2.69; P<0.01), and cardiac insufficiency and arrhythmia(OR=1.77, 95%CI 1.34-2.35; P<0.01). Conclusion The very old individuals show characteristics of higher prevalence of multimorbidity and greater number of chronic diseases or conditions. These conditions may be associated with each other and form special paired chronic conditions.