Hospitalisation events in people with chronic kidney disease as a component of multimorbidity: parallel cohort studies in research and routine care settings

Abstract Background Chronic kidney disease (CKD) typically co-exists with multimorbidity (presence of 2 or more long-term conditions: LTCs). The associations between CKD, multimorbidity and hospitalisation rates are not known. The aim of this study was to examine hospitalisation rates in people with...

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Autores principales:	Michael K. Sullivan, Bhautesh Dinesh Jani, Alex McConnachie, Peter Hanlon, Philip McLoone, Barbara I. Nicholl, Juan-Jesus Carrero, Dorothea Nitsch, David McAllister, Frances S. Mair, Patrick B. Mark
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Chronic kidney disease Multimorbidity Comorbidity Clinical epidemiology Medicine R
Acceso en línea:	https://doaj.org/article/695674ced6b0466b9a7b9b43e7061b0d
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spelling	oai:doaj.org-article:695674ced6b0466b9a7b9b43e7061b0d2021-11-21T12:16:02ZHospitalisation events in people with chronic kidney disease as a component of multimorbidity: parallel cohort studies in research and routine care settings10.1186/s12916-021-02147-61741-7015https://doaj.org/article/695674ced6b0466b9a7b9b43e7061b0d2021-11-01T00:00:00Zhttps://doi.org/10.1186/s12916-021-02147-6https://doaj.org/toc/1741-7015Abstract Background Chronic kidney disease (CKD) typically co-exists with multimorbidity (presence of 2 or more long-term conditions: LTCs). The associations between CKD, multimorbidity and hospitalisation rates are not known. The aim of this study was to examine hospitalisation rates in people with multimorbidity with and without CKD. Amongst people with CKD, the aim was to identify risk factors for hospitalisation. Methods Two cohorts were studied in parallel: UK Biobank (a prospective research study: 2006-2020) and Secure Anonymised Information Linkage Databank (SAIL: a routine care database, Wales, UK: 2011-2018). Adults were included if their kidney function was measured at baseline. Nine categories of participants were used: zero LTCs; one, two, three and four or more LTCs excluding CKD; and one, two, three and four or more LTCs including CKD. Emergency hospitalisation events were obtained from linked hospital records. Results Amongst 469,339 UK Biobank participants, those without CKD had a median of 1 LTC and those with CKD had a median of 3 LTCs. Amongst 1,620,490 SAIL participants, those without CKD had a median of 1 LTC and those with CKD had a median of 5 LTCs. Compared to those with zero LTCs, participants with four or more LTCs (excluding CKD) had high event rates (rate ratios UK Biobank 4.95 (95% confidence interval 4.82–5.08)/SAIL 3.77 (3.71–3.82)) with higher rates if CKD was one of the LTCs (rate ratios UK Biobank 7.83 (7.42–8.25)/SAIL 9.92 (9.75–10.09)). Amongst people with CKD, risk factors for hospitalisation were advanced CKD, age over 60, multiple cardiometabolic LTCs, combined physical and mental LTCs and complex patterns of multimorbidity (LTCs in three or more body systems). Conclusions People with multimorbidity have high rates of hospitalisation. Importantly, the rates are two to three times higher when CKD is one of the multimorbid conditions. Further research is needed into the mechanism underpinning this to inform strategies to prevent hospitalisation in this very high-risk group.Michael K. SullivanBhautesh Dinesh JaniAlex McConnachiePeter HanlonPhilip McLooneBarbara I. NichollJuan-Jesus CarreroDorothea NitschDavid McAllisterFrances S. MairPatrick B. MarkBMCarticleChronic kidney diseaseMultimorbidityComorbidityClinical epidemiologyMedicineRENBMC Medicine, Vol 19, Iss 1, Pp 1-11 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Chronic kidney disease Multimorbidity Comorbidity Clinical epidemiology Medicine R
spellingShingle	Chronic kidney disease Multimorbidity Comorbidity Clinical epidemiology Medicine R Michael K. Sullivan Bhautesh Dinesh Jani Alex McConnachie Peter Hanlon Philip McLoone Barbara I. Nicholl Juan-Jesus Carrero Dorothea Nitsch David McAllister Frances S. Mair Patrick B. Mark Hospitalisation events in people with chronic kidney disease as a component of multimorbidity: parallel cohort studies in research and routine care settings
description	Abstract Background Chronic kidney disease (CKD) typically co-exists with multimorbidity (presence of 2 or more long-term conditions: LTCs). The associations between CKD, multimorbidity and hospitalisation rates are not known. The aim of this study was to examine hospitalisation rates in people with multimorbidity with and without CKD. Amongst people with CKD, the aim was to identify risk factors for hospitalisation. Methods Two cohorts were studied in parallel: UK Biobank (a prospective research study: 2006-2020) and Secure Anonymised Information Linkage Databank (SAIL: a routine care database, Wales, UK: 2011-2018). Adults were included if their kidney function was measured at baseline. Nine categories of participants were used: zero LTCs; one, two, three and four or more LTCs excluding CKD; and one, two, three and four or more LTCs including CKD. Emergency hospitalisation events were obtained from linked hospital records. Results Amongst 469,339 UK Biobank participants, those without CKD had a median of 1 LTC and those with CKD had a median of 3 LTCs. Amongst 1,620,490 SAIL participants, those without CKD had a median of 1 LTC and those with CKD had a median of 5 LTCs. Compared to those with zero LTCs, participants with four or more LTCs (excluding CKD) had high event rates (rate ratios UK Biobank 4.95 (95% confidence interval 4.82–5.08)/SAIL 3.77 (3.71–3.82)) with higher rates if CKD was one of the LTCs (rate ratios UK Biobank 7.83 (7.42–8.25)/SAIL 9.92 (9.75–10.09)). Amongst people with CKD, risk factors for hospitalisation were advanced CKD, age over 60, multiple cardiometabolic LTCs, combined physical and mental LTCs and complex patterns of multimorbidity (LTCs in three or more body systems). Conclusions People with multimorbidity have high rates of hospitalisation. Importantly, the rates are two to three times higher when CKD is one of the multimorbid conditions. Further research is needed into the mechanism underpinning this to inform strategies to prevent hospitalisation in this very high-risk group.
format	article
author	Michael K. Sullivan Bhautesh Dinesh Jani Alex McConnachie Peter Hanlon Philip McLoone Barbara I. Nicholl Juan-Jesus Carrero Dorothea Nitsch David McAllister Frances S. Mair Patrick B. Mark
author_facet	Michael K. Sullivan Bhautesh Dinesh Jani Alex McConnachie Peter Hanlon Philip McLoone Barbara I. Nicholl Juan-Jesus Carrero Dorothea Nitsch David McAllister Frances S. Mair Patrick B. Mark
author_sort	Michael K. Sullivan
title	Hospitalisation events in people with chronic kidney disease as a component of multimorbidity: parallel cohort studies in research and routine care settings
title_short	Hospitalisation events in people with chronic kidney disease as a component of multimorbidity: parallel cohort studies in research and routine care settings
title_full	Hospitalisation events in people with chronic kidney disease as a component of multimorbidity: parallel cohort studies in research and routine care settings
title_fullStr	Hospitalisation events in people with chronic kidney disease as a component of multimorbidity: parallel cohort studies in research and routine care settings
title_full_unstemmed	Hospitalisation events in people with chronic kidney disease as a component of multimorbidity: parallel cohort studies in research and routine care settings
title_sort	hospitalisation events in people with chronic kidney disease as a component of multimorbidity: parallel cohort studies in research and routine care settings
publisher	BMC
publishDate	2021
url	https://doaj.org/article/695674ced6b0466b9a7b9b43e7061b0d
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Hospitalisation events in people with chronic kidney disease as a component of multimorbidity: parallel cohort studies in research and routine care settings

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