Frequency Of Comorbidities In Patients Research Articles

Frequency of Co-Morbidities in Patients with COVID-19

Background: This very contagious virus and the pandemic that resulted from its effects on human health resulted in major disruptions and has virtually interrupted every aspect of daily human life including transportation, business, education, and health care delivery worldwide. Patients of COVID-19 having various co-morbidities have worse outcomes when compared with patients without any co-morbidities. Patients with COVID-19 having history of diabetes mellitus, cardiovascular disease, obesity, hypertension and chronic lung disorders have poor prognosis and often lead to worsening outcomes like Pneumonia & ARDS. Old patients, patients with chronic kidney disease and patients with various cancers are not only at risk for acquiring COVID-19, but there are increased chances of mortality among these patients. Objective: The objective of our study was to determine frequency of co-morbidities in patients with COVID-19 Pneumonia. Study Design: Retrospective Cross-sectional Analytical study. Settings: Isolation Wards/HDU of Allied Hospital, Faisalabad Pakistan. Duration: 06 Months from April 16, 2021 to October 15, 2021. Methods: 100 Patients diagnosed with COVID-19 according to definition and inclusion criteria were included in the study. Following demographic features of the patients admitted in Isolation wards/ HDU’s of Allied Hospital were collected: age; sex; clinical presentation; smoking history; duration between onset of disease and presentation to hospital; history of co-morbid factors like hypertension, diabetes mellitus Obesity, Cardiovascular Disease, Malignancy, history of intake of Immunosuppressive agents. Mean ± SD was calculated for the age of the patients, oxygen saturation of patients and lung involvement of patients. Frequency and percentages were calculated for the Co-Morbidities for COVID-19 pneumonia, gender of the patients, symptoms of patients. Comparative analysis of lung involvement with co-morbidities of patients was done with p value of ≤ 0.05 being considered significant. Results: Our study included 100 patients. 52 patients (52%) were males while 48 (48%) were females. Mean Age of patients was 54.91 ± 15.56 and mean oxygen saturation was 90.88 ± 5.8. Mean lung involvement of patients with COVID-19 was 30.82 ± 16.27. Fever was the commonest symptom amongst the patients included in the study (40%), followed by cough (33%) and shortness of breath (29%). Amongst the co-morbidities in patients with COVID-19, diabetes was found in 54% of the patients, followed by hypertension 34% and ischemic heart disease 6%. Conclusion: Our study concludes that individuals having underlying chronic diseases are more prone to contract COVID-19 virus and eventually develop more severe disease as compared to normal healthy persons. Thus, vaccination of this segment of society and early identification of disease among these people can help reduce morbidity and mortality. Keywords: Co-Morbidities, COVID-19, Diabetes, Hypertension.

Most Frequent Comorbidities in Patients with Lichen Planopilaris: A Cross-Sectional Study

Background: Lichen planopilaris (LPP) is a rare skin disorder, but it is also the most common cause of scarring alopecia in adults. The main cause of this disease is unknown, but it is considered to be related to the immune status of the body. Several comorbidities are reportedly associated with LPP, such as hypertension, depression, thyroiditis, diabetes, and vitiligo. Objective: In the present study, we aimed to investigate the frequency of comorbidities in patients with LPP who were referred to Razi Hospital in Rasht, Iran from 2016 to 2019. Methods: This cross-sectional study involved 60 patients with cicatricial alopecia patches (scarring and irreversible) and clinical signs and symptoms consistent with active LPP. The patients’ demographic data and clinical characteristics were recorded and analyzed using SPSS Version 21, and the level of statistical significance was set at 0.05. Results: The results showed that the most common comorbidities were vitamin D deficiency (24.3%), hypothyroidism (17.6%), anemia (16.2%), asthma and allergy (14.8%), hypertension (13.5%), diabetes (9.5%), and vitiligo (4.5%). There was no statistically significant association of sex, age, or body mass index with LPP according to the presence or absence of underlying disease (P = 0.44, P = 0.108, and P = 0.34, respectively); however, there was a statistically significant difference in the presence of comorbidities according to age (P = 0.018). Conclusion: The results illustrated that women with vitamin D deficiency are more prone to LPP than are patients with other pre-existing underlying diseases.

Metabolic comorbidities of psoriasis (Review).

Psoriasis is a chronic inflammatory and immune-mediated condition, which is no longer considered as being limited to the skin, but may affect the entire body. Epidemiological studies have shown that certain disorders, including obesity, diabetes, liver abnormalities, elevated lipid levels in the blood and metabolic syndrome, may occur more frequently in patients with psoriasis compared with the general population. As psoriasis is a chronic disease, the frequently associated comorbidities must be identified early to ensure timely treatment and, possibly, their prevention. Comorbidities often manifest clinically 1-2 years after the onset of psoriasis and are commonly seen in patients with severe forms of the disease. The association between psoriasis and its comorbidities is not coincidental, but rather based on common pathophysiological mechanisms and risk factors that underlie the increased frequency of comorbidities in patients with psoriasis. The aim of the present review was to emphasize the important role of dermatologists in the early recognition of comorbidities in patients with psoriasis, with a focus on metabolic comorbidities, precisely because the dermatologists are usually the first medical contact due to the predominance of skin lesions. Therefore, these specialists have the responsibility to inform patients on the association between psoriasis and possible multiple comorbidities, devise prevention and treatment plans, or even redirect patients to other specialists.

FREQUENCY OF CO-MORBIDITIES IN PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE

Background: Chronic obstructive pulmonary disease (COPD) is one of the common respiratory conditions which involves the airways and is characterized by persistent airflow obstruction. About five percent of the adult population of the world is being affected by this disease. COPD is associated with several different comorbidities. These comorbidities increase the risk of hospital admission and affect health outcomes in COPD.
 Aims & Objectives: To study the frequency of comorbidities in patients with COPD.
 Place and duration of study: The study was conducted at Department of Pulmonology of FPGMI, Shaikh Zayed Hospital. The duration of study was 6 months from 01-01-2019 to 30-06-2019.
 Patients & Methods: It was a cross sectional study, 115 were enrolled from OPD. The data were recorded in SPSS 20.0. Data were described by using frequencies and percentages and presented in tables, pi-charts, and bar charts.
 Results: Total 115 male COPD patients who consented to participate in the study were registered in the study from OPD. The mean age of the patients was 61.09±10.8 years. The co-morbidities were present in 84.3% patients, and the most common disease was hypertension (65.2%) followed by ischemic heart disease (56.5%) osteoporosis (54.8%), cardiac failure (46.9%), diabetes (40.0%), anemia (36.5%), depression (27.8%), acid peptic disease (26.0%) and malignancy (11.3%). (Figure 2) Thirty one (26.9%) patients had single comorbidity, while 39.1% of patients had two co-morbid conditions, and 18.3% had more than two co-morbidities.
 Conclusion: The co-morbidities in COPD patients are common & most frequent comorbidities include hypertension, ischemic heart disease, diabetes, osteoporosis and depression.

Primary care physician services and the frequency of comorbidities in patients with acute myocardial infarction

Abstract Funding Acknowledgements Type of funding sources: None. Background The management of patients with multiple comorbidities represents a significant burden on healthcare each year. Despite requiring regular medical care to treat chronic conditions, a large number of these patients may not receive proper care. Significant disparities have been identified in patients with multiple comorbidities and those who experience acute coronary syndrome or acute myocardial infarction (AMI). Only limited data exists to identify the impact of comorbidities and utilization of primary care physician (PCP) services on the development of adverse outcomes, such as AMI. Purpose The primary objective was to analyze how PCP services utilization can be associated with comorbidities in patients who experienced an AMI. Methods This study was based on retrospective data analysis which included 250 patients admitted to the Hartford Hospital Emergency Department (ED) for an AMI. Out of these, 27 patients were excluded due to missing documentation. Collected data included age, gender, medications and recorded comorbidities, such as hypertension, hyperlipidemia, diabetes mellitus (DM), chronic kidney disease (CKD) and previous arrhythmia. Each patient was assessed regarding utilization of PCP services. Statistical analysis was performed in order to identify differences between patients with documented PCP services and those without by using the Chi-square test. Results The records allowed for identification of documented PCP services for 172 out of 223 (77.1%) patients. The most common comorbidities were hypertension and hyperlipidemia: in 165 (74.0%) and 157 (70.4%) cases respectively. The most frequent comorbidity was hypertension: 137 out of 172 (79.7%) in pts with PCP vs 28 out of 51 (54.9%) without PCP, and significantly more often in patients with PCP, p< 0.001. Hyperlipidemia was the second most frequent comorbidity: in 130 out of 172 (75.6%) vs 27 out of 51 (52.9%) accordingly, and also significantly more often (p< 0.002) in patients with PCP services. The number of comorbidities ranged from 0-5, including 32 (14.3%) patients without comorbidities: 16 (9.3%) with a PCP and 16 (31.4%) without PCP services. The majority of patients - 108 (48.5% of 223), had 2-3 documented comorbidities: 89 (51.8%) had two and 19 (34.6%) had three. The remaining 40 (17.9%) patients had 4-5 comorbidities: 37 (21.5%) of them with a PCP and 3 (10.3%) without, with a significant difference (p < 0.001) found for patients with a higher number of comorbidities who utilized PCP services. Conclusions Our study shows that the majority of patients who presented with an AMI had one or more comorbidities. Furthermore, patients who did not utilize PCP services had fewer identified comorbidities. This suggests that there may be a significant number of patients who experienced AMI with undiagnosed comorbidities due to not having access to PCP services.

Comorbidities in Patients with Chronic Urticaria

Several comorbidities are frequently associated with chronic urticaria (CU), and some can cause worse prognosis to the disease. The objective was to describe the frequency of comorbidities in patients with CU. This is a retrospective study with data collected from electronic medical records of patients with CU followed up in a tertiary service. Epidemiological data, CU’s classification, frequency of comorbidities were analyzed: esophagitis/gastritis, obesity, systemic arterial hypertension, diabetes mellitus, thyroid diseases, respiratory diseases (rhinitis and/or asthma) and psychological diseases; the frequency of angioedema (AE), exacerbation by NSAIDs and refractoriness to H1 antihistamines. Patients were classified according to the concomitance of comorbidities. There were 102 sequentially selected patients. Respiratory diseases were the most frequent comorbidity (42.2%), followed by systemic arterial hypertension (26.5%). When patients were classified according to the their frequency of comorbidities, there was no statistical difference in relation to the frequency of angioedema, exacerbation by NSAIDs or refractiveness to antihistamines. The greater the number of comorbidities, the greater the number of each disease, progressively, except for thyroid disease and psychic conditions. The group with four or more comorbidities had a higher mean age (57.3 years), longer urticaria time (12.8 years) and greater refractoriness to antihistamines (54.5%). Patients with multiple comorbidities were older, had longer urticaria duration and were more refractory to antihistamines, which may indicate worse prognosis. The progressive increase in the number of comorbidities, in the same patient, favors the hypothesis of CU to behave as a low-grade systemic inflammatory disease.

Ultrasound characteristics of osteophytes in psoriatic arthritis

Objective. To assess the relationship between ultrasound and clinical characteristics of psoriatic arthritis (PsA) and osteophytes detected by ultrasound (US).Methods. Data collection: demographical, clinical, antropometric (body mass index, BMI). US examination included 868 joints and 3348 entheses (bilateral shoulders, acromioclavicular joints, elbows, wrists, hips, knees, ankles; entheses at the projection of these joints (total number is 54). In the joints – synovitis count, Power Doppler (PD) + synovitis count (SC), the number of joints with osteophytes; in entheses – Grey Scale (GS) enthesitis count (EC), PD + EC, count of entheses with structural components (erosion, enthesophytes, calcification).Results. In all, 62 PsA patients were examined: 32 (51.6%) were women, mean age was 43.0 ± 10.4 years, the duration of PsA was 7 (3; 10) years. The number of joints with osteophytes was 314 of 868 (36.2%). US osteophytes were detected in 51 (82.3%) patients. The number of joints with osteophytes correlated with GS EC (r = 0.398; p < 0.01), PD + EC (r = 0.302; p < 0.05), SC (r = 0.425; p < 0.01), and PD + SC (r = 0.322; p < 0.05). Patients without osteophytes, with local and generalized osteophytes were comparable by sex and duration of the disease. In patients with generalized osteophytes, GS EC (p < 0.05), PD + SC (p < 0.05), SC (p < 0.01), comorbid pathology (p < 0.05), BMI (p < 0.05) were significantly higher.Conclusion. The frequency of osteophytes in patients with PsA was high. The number of synovitis and enthesitis, both GC and PD+, was more common in patients with generalized osteophytes, which probably suggests an important role of entheseal and synovial inflammation in PsA in the development of osteophytes. BMI and the frequency of comorbidities in patients with generalized osteophytes were higher.

Do comorbidities impact on quality of life and pain in patients with knee osteoarthritis?

Purpose: People with osteoarthritis (OA) can also present with a number of comorbidities. Several studies have showed that individuals with knee OA are significantly more likely to have comorbidities than individuals without knee OA, both musculoskeletal as well as non-musculoskeletal conditions. Furthermore, studies have shown that the presence of co-existing medical conditions contributes to increased pain and poorer quality of life in people with knee OA. The purpose of this study was to assess the frequency of comorbidities in patients with knee OA entering the Good Life with osteoArthritis in Denmark (GLA:D®) Australia program and evaluate the impact of comorbidities on quality of life and pain. The association of other characteristics such as Body Mass Index (BMI), age and biological sex with pain and quality of life were also investigated. Methods: This was a cross-sectional nationwide registry-based study including patients with knee OA that entered the GLA:D®program in Australia from January 2018 until July 2019. The data in GLA:D®registry was collected through self-reported electronically answered questionnaires at time of entry. Baseline characteristics were extracted from the GLA:D®database regarding BMI, age, sex, affected joint and comorbidities. The examined patient-reported outcome measures (PROMs) consisted of the Knee injury and Osteoarthritis Outcome Score Quality of Life subscale (KOOS QoL), worst pain in the past month (worst pain) and average pain in the past month (average pain). To determine whether patient characteristics (comorbidity, BMI, age and sex) were correlated with the KOOS QoL-score and VAS-scores, Spearman’s rank correlation coefficients were calculated. Further, stepwise multiple linear regression analyses were applied on variables that were significantly associated (p<0.05) with any of the outcomes to conclude which characteristics were most linearly correlated with pain and joint-related quality of life. Adjusted R2 values less than 0.3 were considered very low, 0.3 to 0.5 low, >0.5 to 0.7 moderate and >0.7 strong. A P-value of <0.05 was considered statistically significant. Results: We included 1685 people, of which 1152 were women (68%), 528 were men (31%) and 5 did not specify gender (0.3%), with a median (inter-quartile range) age of 65 years (59-71). The majority of the participants had a BMI > 25; 38% were overweight (BMI 25-29,9) while 43% were obese (BMI ≥ 30). Fifty-nine percent had one or more comorbidities, the majority had 1-2 comorbidities (47% of the total population). Obesity was the most common comorbidity (43%) followed by high blood pressure (12.5%) and diabetes type 2 (5%). We found that BMI had a very low but statistically significant correlation with KOOS QoL (adjusted R2 0.044, p <0.001) and average pain (adjusted R20.028, p <0.001). None of the other included comorbidities in isolation had a statistically significant linear correlation with KOOS QoL, worst pain or average pain. However, cardiac disease, when combined with a higher BMI and lower age, showed a very low, but statistically significant correlation with lower KOOS QoL (adjusted R2 0.060, p <0.001) and a higher level of worst pain (adjusted R2 0.039, p <0.001). Conclusions: We found that BMI showed a small, but statistically significant correlation with KOOS QoL and average pain, indicating that a higher BMI is associated with higher levels of pain and poorer joint-related QoL. None of the other included comorbidities individually were associated with pain or KOOS QoL in people with knee OA. This suggests that the treatment of overweight and obesity in knee OA people could be essential in improving pain and quality of life.

Nationwide Frequency, Sequential Trends, and Impact of Co-morbid Mental Health Disorders on Hospitalizations, Outcomes, and Healthcare Resource Utilization in Adult Congenital Heart Disease

Despite the growing prevalence of adult congenital heart disease (ACHD), data on trends in prevalence of mental health disorders (MHD) among patients with ACHD remain limited. The National Inpatient Sample (2007 to 2014) was queried to identify the frequency and trends of MHD among ACHD hospitalizations (stratification by age, sex, and race); demographics and co-morbidities for ACHD cohorts, with (MHD+) versus without MHD (MHD-); the rate and trends of all-cause in-hospital mortality, disposition, mean length of stay, and hospitalization charges among both cohorts. A total of 11,709 (13.8%, mean age: 49.1 years, 56.0% females, 78.7% white) out of 85,029 ACHD patient encounters had a coexistent MHD (anxiety, depression, mood disorder, or psychosis). ACHD-MHD+ cohort was more often admitted nonelectively (38.1% vs 32.8%, p <0.001) and had a higher frequency of cardiac/extra-cardiac co-morbidities. The trends in prevalence of coexistent MHD increased from 10.3% to 17.5% (70% relative increase) from 2007 to 2014 with a consistently higher prevalence among females (from 13% to 20.3%) compared to males (from 7.6% to 15.5%) (ptrend <0.001). The hospitalization trends with MHD increased in whites (12.1% to 19.8%) and Hispanics (5.9% to 12.7%). All-cause mortality was lower (0.7% vs 1.1%, p = 0.002) in ACHD-MHD+; however, mean length of stay (∼5.7 vs 4.9 days, p <0.001) was higher without significant difference in charges ($97,710 vs $96,058, p = 0.137). ACHD-MHD+ cohort was less often discharged routinely (declining trend) and more frequently transferred to other facilities and required home healthcare (rising trends). In conclusion, this study reveals increasing trends of MHD, healthcare resource utilization and a higher frequency of co-morbidities in patients with ACHD.

Changes in age distribution and frequency of comorbidities in patients in the occupational insurance association treatment process

Due to the demographic development the proportion of older patients has increased. These show at least a higher rate of comorbidities, which affects the length of inpatient hospital stay. Until now no uniform recording exists for such comorbidities within the occupational insurance association system even if the clinical relevance is beyond dispute. Adaptations within the system with increased interdisciplinary treatment are necessary. The aim of this study was to analyze changes in the age distribution and the frequency of comorbidities in patients in the occupational insurance association system. The study was aretrospective analysis of age distribution and comorbidities of all operatively treated occupational insurance association patients in 2005 (n = 631), 2010 (n = 1180) and 2015/2016 (n = 2315). A comparison of the age groups ≤29years, 30-49years, 50-65years and ≥66years was performed. The proportion of patients aged 50-65years showed a significant increase: 2005 (26.5%), 2010 (30.5%) and 2015/2016 (37.3%) (p < 0.001) and an increased proportion of patients with at least 1 comorbidity: 2005 (38.7%), 2010 (52.5%) and 2015/2016 (52.9%) (p = 0.01). This was statistically significant (p < 0.001, p = 0.005) within the age group 30-49years (2005: 31.1%, 2015/2016: 49.0%) and the age group 50-65years (2005: 55.7%, 2015/2016: 67.1%). Significant changes were found for arterial hypertension, morbid obesity, thyroid and respiratory diseases. In addition, there was an increase in multimorbid patients. Achanging age distribution with a tendency to an increased number of older patients and an increased frequency of comorbidities could be determined. In the present documentation system of the occupational insurance association treatment procedure these comorbidities are insufficiently recorded and considered, even though their clinical relevance is indisputable. Adaptations with respect to intensified interdisciplinary cooperation are necessary.

Evaluation of Complience to Treatment and Frequency of Comorbidities in Patients with Stable Chronic Obstructive Pulmonary Disease

Evaluation of Complience to Treatment and Frequency of Comorbidities in Patients with Stable Chronic Obstructive Pulmonary Disease

Impact of comorbidities in pulmonary rehabilitation outcomes in patients with COPD

BackgroundChronic obstructive pulmonary disease (COPD) represents an increasing burden worldwide. COPD can no longer be considered a disease which only involves the lungs, its systemic consequences make it an important risk factor for other chronic comorbidities. AimTo determine the frequency of comorbidities in patients with COPD undergoing a pulmonary rehabilitation program (PRP) and to evaluate the influence of baseline characteristics as well as comorbidities on the outcomes of PRP. MethodsThe present study included all COPD patients who were admitted to a PRP in our unit. The response to PR was measured by the improvement in exercise tolerance (6min walk test), dyspnea (Mahler's Dyspnea Index) and health status (St. George's Respiratory Questionnaire). Results114 patients with COPD were included. Most patients (96.5%) had at least one comorbidity. Metabolic diseases (71.1%), cardiovascular diseases (67.5%), other respiratory conditions (57.9%) and anxiety/depression (21.1%) were the most prevalent ones. 64.9%, 64.9% and 51.1% of the patients improved in terms of exercise tolerance, quality of life and dyspnea, respectively.The overall results were similar in all levels of the disease and in all comorbid subgroups. Logistic regression analysis showed that respiratory failure and ischemic heart disease negatively influenced improvement in health status and anxiety/depression predicted lower improvement in dyspnea. ConclusionPR was associated with improvements in all comorbid subgroups of patients, underlining the important role of exercise training in rehabilitation of those chronic diseases associated with COPD. On the other hand, the presence of comorbidities in COPD patients, if clinically controlled, should not preclude access to PR.

Impacto das comorbilidades num programa de reabilitação respiratória em doentes com doença pulmonar obstrutiva crónica

BackgroundChronic Obstructive Pulmonary Disease (COPD) represents an increasing burden worldwide. COPD can no longer be considered a disease which only involves the lungs, its systemic consequences make it an important risk factor for other chronic comorbidities. AimTo determine the frequency of comorbidities in patients with COPD undergoing a pulmonary rehabilitation program (PRP) and to evaluate the influence of baseline characteristics as well as comorbidities on the outcomes of PRP. MethodsThe present study included all COPD patients that were admitted to a PRP in our unit. The response to PR was measured by the improvement in exercise tolerance (6minute walk test), dyspnea (Mahler's Dyspnea Index) and health status (St. George's Respiratory Questionnaire). Results114 patients with COPD were included. Most patients (96,5%) had at least one comorbidity. Metabolic diseases (71.1%), cardiovascular diseases (67.5%), other respiratory conditions (57.9%) and anxiety/depression (21.1%) were the most prevalent ones. 64.9%, 64.9% and 51.1% of the patients improved in terms of exercise tolerance, quality of life and dyspnea, respectively.The overall results were similar in all levels of the disease and in all comorbid subgroups. Logistic regression analysis showed that respiratory failure and ischemic heart disease negatively influenced improvement in health status and anxiety/depression predicted lower improvement in dyspnea. ConclusionPR was associated with improvements in all comorbid subgroups of patients, underlining the important role of exercise training in rehabilitation of those chronic diseases associated with COPD. On the other hand, the presence of comorbidities in COPD patients, if clinically controlled, should not preclude access to PR.

Comorbid conditions and survival in unselected, newly diagnosed patients with chronic lymphocytic leukemia

Little is known about the spectrum or frequency of comorbidities in patients with chronic lymphocytic leukemia (CLL). We investigated the prevalence and prognostic implications of comorbidities in patients with newly diagnosed CLL. Local/non-referred patients with CLL evaluated by a hematologist at Mayo Clinic within 1 year of diagnosis were eligible for this retrospective review. Of 1195 individuals evaluated for newly-diagnosed CLL between 1995 and 2006, 373 (31%) were local/non-referred. At diagnosis, 89% of these patients had one or more comorbidities, and 46% had at least one major comorbidity. Twenty-six percent of patients failed to meet NCI working group guidelines to participate in a clinical trial. On multi-factor analysis, Rai risk category (1.39 per each risk category increase; p < 0.0001) and age (1.056 per year increase; p < 0.0001) were the only factors associated with overall survival. We conclude that, although common, comorbid conditions are less important than age and stage in predicting prognosis in newly diagnosed patients with CLL. Clinical trials evaluating treatments that are designed to be tolerated by patients who do not meet traditional clinical trial eligibility criteria are needed.