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. 2024 Feb 17;24(1):509.
doi: 10.1186/s12889-024-18006-x.

Chronic diseases spectrum and multimorbidity in elderly inpatients based on a 12-year epidemiological survey in China

Affiliations

Chronic diseases spectrum and multimorbidity in elderly inpatients based on a 12-year epidemiological survey in China

Shan Gao et al. BMC Public Health. .

Abstract

Background: The number and proportion of the elderly population have been continuously increasing in China, leading to the elevated prevalence of chronic diseases and multimorbidity, which ultimately brings heavy burden to society and families. Meanwhile, the status of multimorbidity tends to be more complex in elderly inpatients than community population. In view of the above concerns, this study was designed to investigate the health status of elderly inpatients by analyzing clinical data in Chinese People's Liberation Army (PLA) General Hospital from 2008 to 2019, including the constitution of common diseases, comorbidities, the status of multimorbidity, in-hospital death and polypharmacy among elderly inpatients, so as to better understand the diseases spectrum and multimorbidity of elderly inpatients and also to provide supporting evidence for targeted management of chronic diseases in the elderly.

Methods: A clinical inpatients database was set up by collecting medical records of elderly inpatients from 2008 to 2019 in Chinese PLA General Hospital, focusing on diseases spectrum and characteristics of elderly inpatients. In this study, we collected data of inpatients aged ≥ 65 years old, and further analyzed the constitution of diseases, multimorbidity rates and mortality causes in the past decade. In addition, the prescriptions were also analyzed to investigate the status of polypharmacy in elderly inpatients.

Results: A total of 210,169 elderly patients were hospitalized from January 1st, 2008 to December 31st, 2019. The corresponding number of hospitalizations was 290,833. The average age of the study population was 72.67 years old. Of the total population, 73,493 elderly patients were re-admitted within one year, with the re-hospitalization rate of 25.27%. Malignant tumor, hypertension, ischemic heart disease, diabetes mellitus and cerebrovascular disease were the top 5 diseases. Among the study population, the number of patients with two or more long-term health conditions was 267,259, accounting for 91.89%, with an average of 4.68 diseases. In addition, the average number of medications taken by the study population was 5.4, among which, the proportion of patients taking more than 5 types of medications accounted for 55.42%.

Conclusions: By analyzing the constitution of diseases and multimorbidity, we found that multimorbidity has turned out to be a prominent problem in elderly inpatients, greatly affecting the process of healthy aging and increasing the burden on families and society. Therefore, multidisciplinary treatment should be strengthened to make reasonable preventive and therapeutic strategies to improve the life quality of the elderly. Meanwhile, more attention should be paid to reasonable medications for elderly patients with multimorbidity to avoid preventable side effects caused by irrational medication therapy.

Keywords: Disease spectrum; Elderly; Multimorbidity; Polypharmacy.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
The number of inpatients and hospitalizations from 2008 to 2019. Columns in blue represent the number of male inpatients, while those in red represent the number of female inpatients in each year from 2008 to 2019. The line in blue represents the variation of hospitalizations in males, while that in red represents the variation of hospitalizations in females from 2008 to 2019
Fig. 2
Fig. 2
The regional distribution of the study population
Fig. 3
Fig. 3
The proportion of top 10 diseases and top 10 causes of hospitalization in the study population. (a) the proportion of top 10 diseases of various age groups in male elderly inpatients (b) the proportion of top 10 diseases of various age groups in female elderly inpatients (c) The proportion of top 10 causes of hospitalization of various age groups in male elderly patients (d) The proportion of top 10 causes of hospitalization of various age groups in female elderly inpatients
Fig. 4
Fig. 4
The composition of comorbidities of top 5 diseases in the study population. Malignant tumor, hypertension, ischemic heart disease, diabetes mellitus and cerebrovascular disease are the top 5 diseases in the study population according to the results in the section of the disease distribution in the elderly inpatients. Therefore, we further analyzed the composition of comorbidities in patients with the top 5 diseases
Fig.5
Fig.5
The composition of death causes in various age groups. Lung infection is a common respiratory system disease mainly caused by pathogenic microorganisms, which invade the "lower respiratory tract, alveoli and other lung structures, thereby causing inflammatory reaction [22]
Fig.6
Fig.6
The ranking and proportion of oral medications in the study population. CCB: Calcium channel blocker; ARB: Angiotensin Receptor Blocker; ACEI: Angiotensin Converting Enzyme Inhibitor; DPP-4: Dipeptidyl peptidase-4

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