NDLI: Mortality in a cohort of complex patients with chronic illnesses and multimorbidity: a descriptive longitudinal study

Content Provider	Springer Nature : BioMed Central
Author	Martín-Lesende, I. Recalde, E. Viviane-Wunderling, P. Pinar, T. Borghesi, F. Aguirre, T. Recio, M. Martínez, ME Asua, J.
Abstract	Background Certain advanced chronic conditions (heart failure, chronic lung disease) are associated with high mortality. Nevertheless, most of the time, patients with these conditions are not given the same level of attention or palliative care as those with cancer. The objective of this study was to assess mortality and its association with other variables in a cohort of complex multimorbid patients with heart failure and/or lung disease from two consecutive telemonitoring studies. Methods This multicentre longitudinal study was conducted between 2010 and 2015. We included 83 patients (27 without telemonitoring) with heart failure and/or lung disease with > 1 hospital admission in the previous year and great difficulties leaving home or were housebound. The following variables were indicators of their complex clinical condition: old age (mean: 81 years), comorbidity (Charlson Comorbidity Index score ≥ 2: 86.2 %), both conditions concurrently (54.2 %) and home oxygen therapy (52 %). We assessed mortality (rate, cause and place of death) and its association with: age, sex, telemonitoring, functional status (Barthel score), quality of life (EQ-5D visual analogue scale), number of medications, and all-cause and condition-specific (due to conditions prompting inclusion) admissions during the previous year. Uni- and bivariate analysis and logistic regression were performed, considering p < 0.05 significant. Results A total of 61 patients died within 5 years, representing 31.2 %/year (95 % CI: 23–40.1 %), considering the overall follow-up (sum of individual follow-up days). Of these, 81 % of deaths (95 % CI: 69.1–89–1 %) were due to the condition prompting inclusion, and 83.3 % (95 % CI: 72–90.7 %) died in hospital (median: 8.5 days). Mortality was lower among those under telemonitoring (p = 0.027), and with fewer condition-specific admissions the previous year (p = 0.006); the latter also showed the strongest association in the multivariate analysis (Exp(B) = 6.115). Conclusions Complex patients with multimorbidity had a high mortality rate, generally dying due to the condition for which they had been included, and in hospital (83.3 %). New approaches for managing such patients should be considered, introducing palliative care as required, and using more comprehensive predictors of mortality (functional status and quality of life), together with those related to the illness itself (previous admissions, progression and symptoms).
Related Links	https://bmcpalliatcare.biomedcentral.com/counter/pdf/10.1186/s12904-016-0111-x.pdf
Ending Page	9
Page Count	9
Starting Page	1
File Format	HTM / HTML
DOI	10.1186/s12904-016-0111-x
Journal	BMC Palliative Care
Issue Number	1
Volume Number	15
Language	English
Publisher	BioMed Central
Publisher Date	2016-04-12
Access Restriction	Open
Subject Keyword	Pain Medicine Quality of Life Research Palliative Medicine Mortality Chronic diseases Heart failure Chronic lung disease Elderly Telemonitoring Primary care Hospital admissions
Content Type	Text
Resource Type	Article
Subject	Medicine
Journal Impact Factor	2.5/2023
5-Year Journal Impact Factor	3.2/2023

Sl.	Authority	Responsibilities	Communication Details
1	Ministry of Education (GoI), Department of Higher Education	Sanctioning Authority	https://www.education.gov.in/ict-initiatives
2	Indian Institute of Technology Kharagpur	Host Institute of the Project: The host institute of the project is responsible for providing infrastructure support and hosting the project	https://www.iitkgp.ac.in
3	National Digital Library of India Office, Indian Institute of Technology Kharagpur	The administrative and infrastructural headquarters of the project	Dr. B. Sutradhar bsutra@ndl.gov.in
4	Project PI / Joint PI	Principal Investigator and Joint Principal Investigators of the project	Dr. B. Sutradhar bsutra@ndl.gov.in Prof. Saswat Chakrabarti will be added soon
5	Website/Portal (Helpdesk)	Queries regarding NDLI and its services	support@ndl.gov.in
6	Contents and Copyright Issues	Queries related to content curation and copyright issues	content@ndl.gov.in
7	National Digital Library of India Club (NDLI Club)	Queries related to NDLI Club formation, support, user awareness program, seminar/symposium, collaboration, social media, promotion, and outreach	clubsupport@ndl.gov.in
8	Digital Preservation Centre (DPC)	Assistance with digitizing and archiving copyright-free printed books	dpc@ndl.gov.in
9	IDR Setup or Support	Queries related to establishment and support of Institutional Digital Repository (IDR) and IDR workshops	idr@ndl.gov.in

Impact of telemonitoring home care patients with heart failure or chronic lung disease from primary care on healthcare resource use (the TELBIL study randomised controlled trial)

Effects of a home-based palliative heart failure program on quality of life among the elderly: a clinical trial study

Primary data on symptom burden and quality of life among elderly patients at risk of dying during unplanned admissions to an NHS hospital: a cohort study using EuroQoL and the integrated palliative care outcome scale

Provision of palliative care for chronic heart failure inpatients: how much do we need?

Health care professionals’ attitudes regarding palliative care for patients with chronic heart failure: an interview study

Towards integration of palliative care in patients with chronic heart failure and chronic obstructive pulmonary disease: a systematic literature review of European guidelines and pathways

End-of-life care in general practice: A cross-sectional, retrospective survey of ‘cancer’, ‘organ failure’ and ‘old-age/dementia’ patients

Unmet needs in palliative care for patients with common non-cancer diseases: a cross-sectional study

Race Differences in Quality of Life following a Palliative Care Intervention in Patients with Advanced Heart Failure: Insights from the Palliative Care in Heart Failure Trial.

Mortality in a cohort of complex patients with chronic illnesses and multimorbidity: a descriptive longitudinal study

Similar Documents

Impact of telemonitoring home care patients with heart failure or chronic lung disease from primary care on healthcare resource use (the TELBIL study randomised controlled trial)

Effects of a home-based palliative heart failure program on quality of life among the elderly: a clinical trial study

Primary data on symptom burden and quality of life among elderly patients at risk of dying during unplanned admissions to an NHS hospital: a cohort study using EuroQoL and the integrated palliative care outcome scale

Provision of palliative care for chronic heart failure inpatients: how much do we need?

Health care professionals’ attitudes regarding palliative care for patients with chronic heart failure: an interview study

Towards integration of palliative care in patients with chronic heart failure and chronic obstructive pulmonary disease: a systematic literature review of European guidelines and pathways

End-of-life care in general practice: A cross-sectional, retrospective survey of ‘cancer’, ‘organ failure’ and ‘old-age/dementia’ patients

Unmet needs in palliative care for patients with common non-cancer diseases: a cross-sectional study

Race Differences in Quality of Life following a Palliative Care Intervention in Patients with Advanced Heart Failure: Insights from the Palliative Care in Heart Failure Trial.

Mortality in a cohort of complex patients with chronic illnesses and multimorbidity: a descriptive longitudinal study