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Cross-sectional study of correlates and prevalence of functional and high-risk multimorbidity in an academic HIV practice in New York City
OBJECTIVES: People with HIV have high levels of multimorbidity, but studies often focus on high-risk comorbidities such as hypertension or coronary artery disease. We examined both high-risk and functional comorbidities in an ethnically diverse clinic population to compare the prevalence of comorbid...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BMJ Publishing Group
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8359525/ https://www.ncbi.nlm.nih.gov/pubmed/34380723 http://dx.doi.org/10.1136/bmjopen-2020-047199 |
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author | Siegler, Eugenia Moxley, Jerad Mauer, Elizabeth Glesby, Marshall |
author_facet | Siegler, Eugenia Moxley, Jerad Mauer, Elizabeth Glesby, Marshall |
author_sort | Siegler, Eugenia |
collection | PubMed |
description | OBJECTIVES: People with HIV have high levels of multimorbidity, but studies often focus on high-risk comorbidities such as hypertension or coronary artery disease. We examined both high-risk and functional comorbidities in an ethnically diverse clinic population to compare the prevalence of comorbidities and different patterns of multimorbidity. DESIGN: Retrospective cross-sectional study. SETTING: University-based primary care HIV clinic with two locations in New York City. PARTICIPANTS: Patients who had been seen by a physician at least once between 1 June 2016 and 31 May 2017. PRIMARY AND SECONDARY OUTCOME MEASURES: Data regarding demographics, diagnoses and lab values were downloaded in a one-time data import from the electronic medical record. Comorbidities were classified as high-risk (with major impact on mortality) or functional (with major impact on function), and multimorbidity was determined for both classes in the total sample of 2751. Factors associated with high-risk and functional multimorbidity were determined first through bivariate analysis and then through multivariable median regression in 2013 patients with complete data. RESULTS: Median age was 52 years (IQR 43–59). Cisgendered women comprised 24.6% of the sample, and 31.7% were African-American. Both functional and high-risk comorbidities were common and risk increased with age. Among those 75 and older, median number of both functional and high-risk comorbidities was 3 (IQR 2–4). High-risk comorbidities were associated with age (p<0.001), more years with an HIV diagnosis (p<0.001) and being an African-American (p<0.001). Associated with a higher number of functional comorbidities were age (p<0.001), being a cisgender female (p<0.001), being Hispanic (p=0.01) and more years with an HIV diagnosis (p<0.001). CONCLUSIONS: Comorbidities with functional impact increase with age in parallel to those with a more direct impact on mortality and should be assessed and monitored, especially as the population with HIV ages. |
format | Online Article Text |
id | pubmed-8359525 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | BMJ Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-83595252021-08-30 Cross-sectional study of correlates and prevalence of functional and high-risk multimorbidity in an academic HIV practice in New York City Siegler, Eugenia Moxley, Jerad Mauer, Elizabeth Glesby, Marshall BMJ Open HIV/AIDS OBJECTIVES: People with HIV have high levels of multimorbidity, but studies often focus on high-risk comorbidities such as hypertension or coronary artery disease. We examined both high-risk and functional comorbidities in an ethnically diverse clinic population to compare the prevalence of comorbidities and different patterns of multimorbidity. DESIGN: Retrospective cross-sectional study. SETTING: University-based primary care HIV clinic with two locations in New York City. PARTICIPANTS: Patients who had been seen by a physician at least once between 1 June 2016 and 31 May 2017. PRIMARY AND SECONDARY OUTCOME MEASURES: Data regarding demographics, diagnoses and lab values were downloaded in a one-time data import from the electronic medical record. Comorbidities were classified as high-risk (with major impact on mortality) or functional (with major impact on function), and multimorbidity was determined for both classes in the total sample of 2751. Factors associated with high-risk and functional multimorbidity were determined first through bivariate analysis and then through multivariable median regression in 2013 patients with complete data. RESULTS: Median age was 52 years (IQR 43–59). Cisgendered women comprised 24.6% of the sample, and 31.7% were African-American. Both functional and high-risk comorbidities were common and risk increased with age. Among those 75 and older, median number of both functional and high-risk comorbidities was 3 (IQR 2–4). High-risk comorbidities were associated with age (p<0.001), more years with an HIV diagnosis (p<0.001) and being an African-American (p<0.001). Associated with a higher number of functional comorbidities were age (p<0.001), being a cisgender female (p<0.001), being Hispanic (p=0.01) and more years with an HIV diagnosis (p<0.001). CONCLUSIONS: Comorbidities with functional impact increase with age in parallel to those with a more direct impact on mortality and should be assessed and monitored, especially as the population with HIV ages. BMJ Publishing Group 2021-08-11 /pmc/articles/PMC8359525/ /pubmed/34380723 http://dx.doi.org/10.1136/bmjopen-2020-047199 Text en © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) . |
spellingShingle | HIV/AIDS Siegler, Eugenia Moxley, Jerad Mauer, Elizabeth Glesby, Marshall Cross-sectional study of correlates and prevalence of functional and high-risk multimorbidity in an academic HIV practice in New York City |
title | Cross-sectional study of correlates and prevalence of functional and high-risk multimorbidity in an academic HIV practice in New York City |
title_full | Cross-sectional study of correlates and prevalence of functional and high-risk multimorbidity in an academic HIV practice in New York City |
title_fullStr | Cross-sectional study of correlates and prevalence of functional and high-risk multimorbidity in an academic HIV practice in New York City |
title_full_unstemmed | Cross-sectional study of correlates and prevalence of functional and high-risk multimorbidity in an academic HIV practice in New York City |
title_short | Cross-sectional study of correlates and prevalence of functional and high-risk multimorbidity in an academic HIV practice in New York City |
title_sort | cross-sectional study of correlates and prevalence of functional and high-risk multimorbidity in an academic hiv practice in new york city |
topic | HIV/AIDS |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8359525/ https://www.ncbi.nlm.nih.gov/pubmed/34380723 http://dx.doi.org/10.1136/bmjopen-2020-047199 |
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