Multimorbidity and mortality: A 15-year longitudinal registry-based nationwide Danish population study
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Multimorbidity and mortality : A 15-year longitudinal registry-based nationwide Danish population study. / Willadsen, Tora Grauers; Siersma, Volkert Dirk; Nicolaisdottir, Dagny Ros; Køster-Rasmussen, Rasmus; Jarbøl, Dorte Ejg; Reventlow, Susanne; Mercer, Stewart ; Olivarius, Niels de Fine.
In: Journal of Comorbidity, Vol. 8, 8, 2018, p. 1-9.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Multimorbidity and mortality
T2 - A 15-year longitudinal registry-based nationwide Danish population study
AU - Willadsen, Tora Grauers
AU - Siersma, Volkert Dirk
AU - Nicolaisdottir, Dagny Ros
AU - Køster-Rasmussen, Rasmus
AU - Jarbøl, Dorte Ejg
AU - Reventlow, Susanne
AU - Mercer, Stewart
AU - Olivarius, Niels de Fine
PY - 2018
Y1 - 2018
N2 - Background: Knowledge about prevalent and deadly combinations of multimorbidity is needed.Objective: To determine the nationwide prevalence of multimorbidity and estimate mortality for the most prevalent combinations of 1-5 diagnosis groups. Furthermore, to assess the excess mortality of the combination of two groups compared to the product of mortality associated with the single groups. Design: A prospective cohort study using Danish registries and including 3 986 209 people aged ≥18 years on 1 January, 2000. Multimorbidity was defined as having diagnoses from at least two of ten diagnosis groups: lung, musculoskeletal, endocrine, mental, cancer, neurological, gastrointestinal, cardiovascular, kidney, and sensory organs. Logistic regression (odds ratios, OR) and Ratio of ORs (ROR) were used to study mortality and excess mortality.Results: Prevalence of multimorbidity was 7.1% in the Danish population. The most prevalent combination (0.4%) was the musculoskeletal-cardiovascular which had double the mortality (OR 2.03) compared to persons not belonging to any of the diagnosis groups but showed no excess mortality (ROR 0.97). The neurological-cancer combination had the highest mortality (OR 6.35), was less prevalent (0.07%), and had no excess mortality (ROR 0.94). Cardiovascular-lung was moderately prevalent (0.2%), had high mortality (OR 5.75), and had excess mortality (ROR 1.18). Endocrine-kidney had high excess mortality (ROR 1.81) and cancer-mental had low excess mortality (ROR 0.66). Mortality increased with the number of groups.Conclusions: All combinations had increased mortality risk with some of them having up to a six-fold increased risk. Mortality increased with the number of diagnosis groups. Most combinations did not increase mortality above that expected, i.e. were additive rather than synergistic.
AB - Background: Knowledge about prevalent and deadly combinations of multimorbidity is needed.Objective: To determine the nationwide prevalence of multimorbidity and estimate mortality for the most prevalent combinations of 1-5 diagnosis groups. Furthermore, to assess the excess mortality of the combination of two groups compared to the product of mortality associated with the single groups. Design: A prospective cohort study using Danish registries and including 3 986 209 people aged ≥18 years on 1 January, 2000. Multimorbidity was defined as having diagnoses from at least two of ten diagnosis groups: lung, musculoskeletal, endocrine, mental, cancer, neurological, gastrointestinal, cardiovascular, kidney, and sensory organs. Logistic regression (odds ratios, OR) and Ratio of ORs (ROR) were used to study mortality and excess mortality.Results: Prevalence of multimorbidity was 7.1% in the Danish population. The most prevalent combination (0.4%) was the musculoskeletal-cardiovascular which had double the mortality (OR 2.03) compared to persons not belonging to any of the diagnosis groups but showed no excess mortality (ROR 0.97). The neurological-cancer combination had the highest mortality (OR 6.35), was less prevalent (0.07%), and had no excess mortality (ROR 0.94). Cardiovascular-lung was moderately prevalent (0.2%), had high mortality (OR 5.75), and had excess mortality (ROR 1.18). Endocrine-kidney had high excess mortality (ROR 1.81) and cancer-mental had low excess mortality (ROR 0.66). Mortality increased with the number of groups.Conclusions: All combinations had increased mortality risk with some of them having up to a six-fold increased risk. Mortality increased with the number of diagnosis groups. Most combinations did not increase mortality above that expected, i.e. were additive rather than synergistic.
U2 - 10.1177/2235042X18804063
DO - 10.1177/2235042X18804063
M3 - Journal article
VL - 8
SP - 1
EP - 9
JO - Journal of Comorbidity
JF - Journal of Comorbidity
SN - 2235-042X
M1 - 8
ER -
ID: 218655977