Association between multimorbidity and hospitalization in older adults: systematic review and meta-analysis

Author:

Rodrigues Luciana Pereira12ORCID,de Oliveira Rezende Andréa Toledo12,Delpino Felipe Mendes3,Mendonça Carolina Rodrigues12,Noll Matias1245,Nunes Bruno Pereira6,de Oliviera Cesar7,Silveira Erika Aparecida124

Affiliation:

1. Postgraduate Program in Health Sciences , School of Medicine, , Goiânia, Brazil

2. Federal University of Goiás , School of Medicine, , Goiânia, Brazil

3. Department of Nursing in Public Health , Federal University of Pelotas, Pelotas, Brazil

4. Federal Institute Goiano , Campus Ceres, Goiás, Brazil

5. Department of Sports Science and Clinical Biomechanics , University of Southern Denmark, Odense, Denmark

6. Postgraduate Program in Nursing , Federal University of Pelotas, Pelotas, Rio Grande do Sul, Brazil

7. Department of Epidemiology & Public Health , Institute of Epidemiology & Health Care, University College London, London, UK

Abstract

Abstract Background Multimorbidity is defined as the presence of multiple chronic conditions in the same individual. Multimorbidity is more prevalent in older adults and can lead to several adverse health outcomes. Methods We systematically reviewed evidence from observational studies to verify the association between multimorbidity and hospitalization in older adults. Furthermore, we also aimed to identify whether it changes according to gender, advanced age, institutionalization, and wealth of the country of residence. We searched the PubMed, Embase and Scopus databases from December 2020 to April 2021. The analysed outcomes were as follows: hospitalization, length of stay and hospital readmission. Results Of the 6,948 studies identified in the databases, 33 were included in this review. From the meta-analysis results, it was found that multimorbidity, regardless of the country’s wealth, was linked to hospitalization in older adults (OR = 2.52, CI 95% = 1.87–3.38). Both definitions of multimorbidity, ≥2 (OR = 2.35, 95% CI = 1.34–4.12) and ≥3 morbidities (OR = 2.52, 95% CI = 1.87–3.38), were associated with hospitalization. Regardless of gender, multimorbidity was associated with hospitalization (OR = 1.98, 95% CI = 1.67–2.34) and with readmission (OR = 1.07, 95% CI = 1.04–1.09). However, it was not possible to verify the association between multimorbidity and length of stay. Conclusions Multimorbidity was linked to a higher hospitalization risk, and this risk was not affected by the country’s wealth and patient’s gender. Multimorbidity was also linked to a higher hospital readmission rate in older adults. PROSPERO Registration (Registration number: CRD42021229328).

Funder

Economic and Social Research Council

Publisher

Oxford University Press (OUP)

Subject

Geriatrics and Gerontology,Aging,General Medicine

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