000132803 001__ 132803
000132803 005__ 20240315113108.0
000132803 0247_ $$2doi$$a10.37871/jbres1601
000132803 0248_ $$2sideral$$a137685
000132803 037__ $$aART-2022-137685
000132803 041__ $$aeng
000132803 100__ $$aBernabeu Wittel, M.
000132803 245__ $$aCharacterization of Patients with Chronic Diseases and Complex Care Needs: A New High-Risk Emergent Population
000132803 260__ $$c2022
000132803 5060_ $$aAccess copy available to the general public$$fUnrestricted
000132803 5203_ $$aBackground: To analyze the prevalence and main epidemiological, clinical and outcome features of in-Patients with Complex Chronic conditions (PCC) in internal medicine areas, using a pragmatic working definition.
Methods: Prospective study in 17 centers from Spain, with 97 in-hospital, monthly prevalence cuts. A PCC was considered when criteria of polypathological patient (two or more major chronic diseases) were met, or when a patient suffered one major chronic disease plus one or more of nine predefined complexity criteria like socio-familial risk, alcoholism or malnutrition among others (PCC without polypathology). A complete set of baseline features as well as 12-months survival were collected. Then, we compared clinical, outcome variables, and PROFUND index accuracy between polypathological patients and PCC without polypathology.
Results: The global prevalence of PCC was 61% (40% of them were polypathological patients, and 21% PCC withouth polypathology) out of the 2178 evaluated patients. Their median age was 82 (59.5% men), suffered 2.3 ± 1.1 major diseases (heart diseases (70.5%), neurologic (41.5%), renal (36%), and lung diseases (26%)), 5.5 ± 2.5 other chronic conditions, met 2.5 ± 1.5 complexity criteria, and presented functional decline (Barthel index 55 (25-90)). Compared to polypathological patients, the subgroup of PCC without polypathology were younger, with a different pattern of major diseases and comorbidities, a better functional status, and lower 12-months mortality rates ((36.2% vs 46.8%; p = .003; OR 0.7(0.48-0.86). The PROFUND index obtained adequate calibration and discrimination power (AUC-ROC 0.67 (0.63-0.69)) in predicting 12-month mortality of PCC.
Conclusion: Patients with complex chronic conditions are highly prevalent in internal medicine areas; their clinical pattern has changed in parallel to socio-epidemiological modifications, but their death-risk is still adequately predicted by PROFUND index.
000132803 540__ $$9info:eu-repo/semantics/openAccess$$aby$$uhttp://creativecommons.org/licenses/by/3.0/es/
000132803 655_4 $$ainfo:eu-repo/semantics/article$$vinfo:eu-repo/semantics/publishedVersion
000132803 700__ $$aGarcia Romero, L.
000132803 700__ $$aMurcia Zaragoza, J.
000132803 700__ $$aGamez Mancera, R.
000132803 700__ $$aAparicio Santos, R.
000132803 700__ $$0(orcid)0000-0002-3132-2171$$aDiez Manglano, J.$$uUniversidad de Zaragoza
000132803 700__ $$aLopez de la Fuente, M.
000132803 700__ $$aVogt Sanchez, E.A.
000132803 700__ $$aVillarino Marzo, M.
000132803 700__ $$aAquilino Tari, A.
000132803 700__ $$aHerranz Martinez, S.
000132803 700__ $$aDiaz Jimenez, P.
000132803 700__ $$aOllero Baturone, M.
000132803 700__ $$aRosich Peris, M.P.
000132803 700__ $$aCronicom Project researchers
000132803 7102_ $$11007$$2610$$aUniversidad de Zaragoza$$bDpto. Medicina, Psiqu. y Derm.$$cArea Medicina
000132803 773__ $$g3, 11 (2022), 1321-1336$$pJ. biomed. res. environ. sci.$$tJournal of biomedical research & environmental sciences$$x2766-2276
000132803 8564_ $$s1180721$$uhttps://zaguan.unizar.es/record/132803/files/texto_completo.pdf$$yVersión publicada
000132803 8564_ $$s2777688$$uhttps://zaguan.unizar.es/record/132803/files/texto_completo.jpg?subformat=icon$$xicon$$yVersión publicada
000132803 909CO $$ooai:zaguan.unizar.es:132803$$particulos$$pdriver
000132803 951__ $$a2024-03-15-08:50:07
000132803 980__ $$aARTICLE