The prevalence and determinants of multimorbidity in hospitalized patients with heart failure

Abstract

Objective: The aim of this study was to assess the prevalence of multimorbidity and co-existed diseases in hospitalized patients with heart failure (HF) in relation to age and gender.

Methods: The nationwide cross-sectional survey had been conducted in Poland (April-November 2013), in 260 randomly selected hospital wards. A trained nurse contacted with one physician, drawn from the list of all doctors working in the selected hospital's wards, who completed the study questionnaires regarding to clinical characteristics of the last five HF patients, who were discharged from an internal or cardiology ward.

Results: Mean age ± SD of the patients was 72.1 ± 10.1 years, 50% were female but the women were significantly older than men. Criterion of multimorbidity met almost 100% of the HF patients. There were no significant differences in the number of co-existed cardiovascular (CV) and non-CV diseases according to gender, but different clinical profile of HF men and women was observed. Women more frequently had thyroid disease, peripheral artery disease and cognitive impairment, whereas men was characterized by higher prevalence of cardiac, pulmonary and hepatic diseases. The co-morbidity significantly increased with age, notably due to increasing prevalence of non-CV diseases. Diabetes, chronic kidney disease, hypercholesterolemia and anemia were the most common non-CV diseases. Among HF patients, 83% suffered from three or more co-morbidities.

Conclusions: The study confirms, that multimorbidity is a considerable problem in patients with HF. Besides age, multimorbidity pattern is strongly dependent on gender. The multidisciplinary approach is warranted in particular in elderly subjects who su er from HF.

Keywords: co-morbidity; cross-sectional survey; heart failure; hospital settings; multimorbidity.